RN Supervisor - Utilization Management (Remote)

Centene Management Company LLC; Missouri; Hybrid; USD 75,000 - 135,000; Full time

Job summary

Centene Management Company LLC is seeking a seasoned nurse leader to supervise the Prior Authorization, Concurrent Review, and/or Retrospective Review teams, ensuring high‑quality, compliant utilization management for members. The role supports remote work within the continental United States and offers exposure to regulatory standards and performance improvement initiatives.

The ideal candidate holds a nursing degree with RN licensure and 4+ years of UM experience, with strong coaching,

Qualifications

• Graduate of an accredited nursing program or Bachelor's degree.
• 4+ years of related UM experience.
• Knowledge of utilization management principles preferred.

Responsibilities

• Monitors UM resources to ensure adherence to performance, compliance, quality, and efficiency standards.
• Collaborates with utilization management team to resolve complex care member issues.
• Maintains knowledge of regulations, accreditation standards, and industry best practices related to utilization management.
• Works with UM team and senior management to identify opportunities for process and quality improvements.
• Educates and provides resources for UM initiatives and facilitates communication between UM, members, and providers.
• Monitors UM nurses and ensures compliance with guidelines, policies, and procedures.
• Develops and implements UM policies, procedures, and guidelines.
• Evaluates UM team performance and provides feedback on performance and career milestones.
• Provides coaching and guidance to UM team to ensure adherence to quality and performance standards.
• Assists with onboarding, hiring, and training UM team members.
• Leads and champions change within scope of responsibility.
• Performs other duties as assigned.

Skills

RN

Team supervision

Utilization management

Policy compliance

Education

Nursing degree

Bachelor's degree

Job description

Centene Management Company LLC is seeking a seasoned nurse leader to supervise the Prior Authorization, Concurrent Review, and/or Retrospective Review teams, ensuring high‑quality, compliant utilization management for members. The role supports remote work within the continental United States and offers exposure to regulatory standards and performance improvement initiatives.

The ideal candidate holds a nursing degree with RN licensure and 4+ years of UM experience, with strong coaching,