Opportunity Description
You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.
**NOTE: REMOTE RN candidates may reside in any state but a current and active RN license from the state of California is strongly preferred**
**Position Purpose:** Supervises Prior Authorization, Concurrent Review, and/or Retrospective Review Clinical Review team to ensure appropriate care to members. Supervises day-to-day activities of utilization management team.
+ Monitors and tracks 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 m...
**NOTE: REMOTE RN candidates may reside in any state but a current and active RN license from the state of California is strongly preferred**
**Position Purpose:** Supervises Prior Authorization, Concurrent Review, and/or Retrospective Review Clinical Review team to ensure appropriate care to members. Supervises day-to-day activities of utilization management team.
+ Monitors and tracks 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 m...
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