Remote RN Supervisor Utilization Management Lead, CA License

Centene Corporation; Town of Florida (NY); Hybrid; USD 75,000 - 135,000; Full time

Benefits offered by this job

Competitive pay

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off and holidays

Flexible work arrangements

Job summary

Centene Corporation seeks an experienced RN supervisor to lead the Prior Authorization, Concurrent Review, and Retrospective Review teams within utilization management. The role ensures compliant, high-quality care, monitors performance, and champions process improvement across the UM function.

Applicants must have an RN license in good standing and be willing to obtain or verify California licensure/clearance. Remote/hybrid options available; strong emphasis on leadership and compliance.

Qualifications

• Graduate of an accredited nursing program with a bachelor’s degree and 4+ years in related experience.
• Strong knowledge of appeals and utilization management principles preferred.
• RN license in good standing with state licensure requirements.

Responsibilities

• Supervises Prior Authorization, Concurrent Review, and Retrospective Review teams.
• Monitors UM resources to ensure quality, compliance, and efficiency.
• Educates teams on initiatives and maintains policy and procedure adherence.
• Leads implementation of UM policies and provides coaching and feedback.

Skills

Nursing

Team leadership

Utilization management

Regulatory compliance

Coaching and mentoring

Education

Bachelor's degree in Nursing

Job description

Centene Corporation seeks an experienced RN supervisor to lead the Prior Authorization, Concurrent Review, and Retrospective Review teams within utilization management. The role ensures compliant, high-quality care, monitors performance, and champions process improvement across the UM function.

Applicants must have an RN license in good standing and be willing to obtain or verify California licensure/clearance. Remote/hybrid options available; strong emphasis on leadership and compliance.