RN Supervisor: Utilization Management Lead

Centene Corporation; Maryland; Hybrid; USD 75,000 - 135,000; Full time

Job summary

Centene Corporation is seeking a RN Supervisor for Utilization Management to oversee prior authorization, concurrent and retrospective reviews for California members. Mon-Fri, 8:00 a.m. to 5:00 p.m. PT, with Pacific Time schedule.

Requires CA RN licensure, 4+ years in utilization management, and strong managed care knowledge. The role emphasizes process improvements, regulatory compliance, and staff coaching within a supportive team.

Qualifications

• RN license in good standing with state licensure.
• 4+ years of experience in utilization management within managed care.
• Experience handling appeals and knowledge of UM principles.

Responsibilities

• Monitors and tracks UM resources to ensure adherence to standards.
• Collaborates with UM team to resolve complex care issues.
• Educates the UM team on key initiatives and ensures ongoing communication.

Skills

Nursing leadership

Utilization management

Staff coaching

Regulatory compliance

Quality improvement

Healthcare management

Education

Bachelor's degree in Nursing

Graduate of Accredited School of Nursing

Tools

CMCN certification

Job description

Centene Corporation is seeking a RN Supervisor for Utilization Management to oversee prior authorization, concurrent and retrospective reviews for California members. Mon-Fri, 8:00 a.m. to 5:00 p.m. PT, with Pacific Time schedule.

Requires CA RN licensure, 4+ years in utilization management, and strong managed care knowledge. The role emphasizes process improvements, regulatory compliance, and staff coaching within a supportive team.