Remote RN Utilization Management Supervisor

centene; United States; Hybrid; USD 75,000 - 135,000; Full time

Benefits offered by this job

Health insurance

401K

Stock purchase plans

Tuition reimbursement

Paid time off

Flexible schedules

Job summary

Centene is seeking a Senior Utilization Management Leader to supervise Prior Authorization, Concurrent Review, and Retrospective Review teams, ensuring appropriate care for members. This role oversees day-to-day UM operations and collaborates with senior management to drive performance.

Requires RN licensure and a Bachelor's degree with 4+ years in utilization management or related fields. The position supports remote, hybrid, or field/office work arrangements and offers a comprehensive benefits

Qualifications

• Graduate of an Accredited School of Nursing or a Bachelor's degree with 4+ years of related experience.
• RN - State Licensure required.

Responsibilities

• Monitors UM resources to ensure adherence to standards.
• Collaborates with UM team to resolve care issues.
• Maintains knowledge of regulations and accreditation standards.
• Identifies opportunities for process and quality improvements in UM.
• Educates and provides resources for UM staff on key initiatives.
• Leads and coaches UM nurses to ensure quality and performance.
• Oversees onboarding, hiring, and training of UM staff.
• Ensures compliance with policies and procedures.

Education

Bachelor's degree in Nursing

Job description

Centene is seeking a Senior Utilization Management Leader to supervise Prior Authorization, Concurrent Review, and Retrospective Review teams, ensuring appropriate care for members. This role oversees day-to-day UM operations and collaborates with senior management to drive performance.

Requires RN licensure and a Bachelor's degree with 4+ years in utilization management or related fields. The position supports remote, hybrid, or field/office work arrangements and offers a comprehensive benefits