Remote RN Supervisor — Utilization Management Leader

Centene Corporation; United States; Remote; USD 75,000 - 135,000; Full time

Benefits offered by this job

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off & holidays

Flexible work arrangements

Job summary

Centene Corporation is seeking a Nursing leader to supervise the Utilization Management team, including Prior Authorization, Concurrent Review, and Retrospective Review. You will guide staff to ensure appropriate care and compliance with regulatory standards.

The role emphasizes coaching, policy development, and performance improvement within a remote/hybrid setting across states. Requires RN licensure and 4+ years of related experience in managed care.

Qualifications

• Graduate of an Accredited School of Nursing or Bachelor’s degree and 4+ years of related experience.
• Strong knowledge of appeals and utilization management principles.
• Experience in managed care/MCO environments preferred.

Responsibilities

• Supervises Prior Authorization, concurrent and retrospective reviews.
• Oversees day-to-day utilization management operations and staff.
• Ensures compliance with guidelines, policies and procedures.
• Identifies opportunities for process and quality improvements.
• Provides coaching and onboarding for team members.

Skills

Utilization management

Nurse leadership

Regulatory knowledge

Clinical coordination

Education

Bachelor’s degree

RN licensure

Tools

CMCN certification

Job description

Centene Corporation is seeking a Nursing leader to supervise the Utilization Management team, including Prior Authorization, Concurrent Review, and Retrospective Review. You will guide staff to ensure appropriate care and compliance with regulatory standards.

The role emphasizes coaching, policy development, and performance improvement within a remote/hybrid setting across states. Requires RN licensure and 4+ years of related experience in managed care.