Remote RN: Utilization Management Supervisor
Centene Management Company LLC
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Benefits offered by this job
Job summary
Centene Management Company LLC seeks an RN leader to supervise Prior Authorization, Concurrent Review, and Retrospective Review teams, ensuring appropriate care for members. This remote role requires an active Nevada RN license or a compact license with Nevada licensure application.
Typical hours are Monday–Friday, 8AM–5PM PST, with responsibilities spanning UM performance, compliance, and process improvements.
Qualifications
- Graduate of an Accredited School of Nursing or Bachelor's degree and 4+ years of related experience.
- Knowledge of utilization management principles preferred.
Responsibilities
- Monitors and supervises UM resources to ensure performance, compliance, quality and efficiency.
- Collaborates with utilization management team to resolve complex care member issues.
- Maintains knowledge of regulations and accreditation standards related to utilization management.
- Identifies opportunities for process and quality improvements within utilization management.
- Provides coaching and guidance to UM team to ensure adherence to standards.
- Onboards, hires and trains UM team members and leads change initiatives.
Skills
Education
Job description
Centene Management Company LLC seeks an RN leader to supervise Prior Authorization, Concurrent Review, and Retrospective Review teams, ensuring appropriate care for members. This remote role requires an active Nevada RN license or a compact license with Nevada licensure application.
Typical hours are Monday–Friday, 8AM–5PM PST, with responsibilities spanning UM performance, compliance, and process improvements.
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