RN Supervisor - Utilization Management (Remote)

Centene Corporation; Arkansas; On-site; USD 75,000 - 135,000; Full time

Job summary

Centene Corporation is seeking an RN Supervisor to lead the Prior Authorization, Concurrent Review, and Retrospective Review teams, ensuring high-quality utilization management and member care. The role requires a California RN license background check and licensure prior to start.

Responsibilities include monitoring UM resources, policy development with senior management, and coaching the UM team. Remote candidates are welcome with strong CA licensure, with local opportunities in the US.

Qualifications

• Nursing degree from an accredited school.
• 4+ years of related experience in utilization management or appeals.
• RN license required for practice in appropriate state.

Responsibilities

• Supervises Prior Authorization, Concurrent Review, and Retrospective Review teams to ensure appropriate care.
• Monitors UM resources to ensure adherence to standards.
• Educates and provides resources for the UM team on initiatives and communication with members and providers.
• Develops and implements UM policies and guidelines with senior management.
• Onboards, hires, and trains UM team members and provides coaching.

Skills

Utilization management

Appeals process

Leadership

Coaching

Education

Nursing degree (BSN or higher)

Accredited nursing program

Job description

Centene Corporation is seeking an RN Supervisor to lead the Prior Authorization, Concurrent Review, and Retrospective Review teams, ensuring high-quality utilization management and member care. The role requires a California RN license background check and licensure prior to start.

Responsibilities include monitoring UM resources, policy development with senior management, and coaching the UM team. Remote candidates are welcome with strong CA licensure, with local opportunities in the US.