Job 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.
***POSITION IS REMOTE WITH POTENTIAL FOR WEEKEND, HOLIDAY AND ON-CALL***
**RN WITH COMPACT LICENSE 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 relate...
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