Remote RN Supervisor, Utilization Management

Centene Management Company LLC; United States; Remoto; USD 75.000 - 135.000; Tempo pieno

Descrizione del lavoro

Centene Management Company LLC is seeking a Senior Nurse Supervisor for Utilization Management. You will oversee Prior Authorization, Concurrent, and Retrospective Review teams to ensure appropriate care for members, while managing day-to-day UM operations in a remote capacity.

Required is an RN license (Nevada or compact with Nevada licensure), a nursing degree, and 4+ years’ related experience. The role supports a 8AM-5PM PST schedule and offers comprehensive Centene benefits.

Competenze

• Graduate of an Accredited School of Nursing or Bachelor’s degree is required.
• 4+ years of related experience.
• Knowledge of utilization management principles preferred.

Mansioni

• Supervises Prior Authorization, Concurrent Review, and/or Retrospective Review teams to ensure appropriate care.
• Oversees day-to-day activities of the utilization management team.
• Monitors UM resources to ensure adherence to performance, quality, and efficiency standards.
• Collaborates with the UM team to resolve complex member issues.
• Educates the UM team on key initiatives and facilitates communication with members and providers.
• Develops and implements UM policies and guidelines with senior management.
• Coaches and guides staff to meet quality and performance standards.
• Participates in onboarding, hiring, and training of UM staff.

Formazione

Bachelor’s degree in Nursing

RN - Registered Nurse licensure

Descrizione del lavoro

Centene Management Company LLC is seeking a Senior Nurse Supervisor for Utilization Management. You will oversee Prior Authorization, Concurrent, and Retrospective Review teams to ensure appropriate care for members, while managing day-to-day UM operations in a remote capacity.

Required is an RN license (Nevada or compact with Nevada licensure), a nursing degree, and 4+ years’ related experience. The role supports a 8AM-5PM PST schedule and offers comprehensive Centene benefits.