Remote RN: Utilization & Prior Authorization Lead

Centene Corp.; Oklahoma; Híbrido; USD 87.000 - 161.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Remote work option

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off

Descripción de la vacante

Centene Corp. is seeking an experienced nurse leader in Oklahoma for a remote role overseeing Prior Authorization, Concurrent Review, Retrospective Review, and Appeals.

The position requires an active RN license and supervisory experience, with strong proficiency in Microsoft Office and excellent communication skills. The ideal candidate will guide utilization management, coordinate with providers, and ensure compliant, high-quality care for members.

Formación

• Bachelor's degree or nursing degree with 5+ years of related experience.
• 2+ years supervisory experience preferred.
• Knowledge of utilization management principles preferred.

Responsabilidades

• Manage Prior Authorization, Concurrent Review, Retrospective Review, and Appeals teams to ensure appropriate member care.
• Oversee utilization management issues related to member care and provider interactions.
• Coordinate operations within utilization management to maintain efficiency and quality.

Conocimientos

Healthcare leadership

Utilization management

Microsoft Office proficiency

Communication skills

Customer service

Educación

Bachelor's degree

Nursing degree (RN)

Herramientas

Microsoft Office

Descripción del empleo

Centene Corp. is seeking an experienced nurse leader in Oklahoma for a remote role overseeing Prior Authorization, Concurrent Review, Retrospective Review, and Appeals.

The position requires an active RN license and supervisory experience, with strong proficiency in Microsoft Office and excellent communication skills. The ideal candidate will guide utilization management, coordinate with providers, and ensure compliant, high-quality care for members.