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Centene Corporation: Concurrent Review Nurse I — Remote Available

Centene Corporation

This is a Full-time position in Lost Creek, FL posted November 11, 2021.

You could be the one who changes everything for our 25 million members.

Centene is transforming the health of our communities, one person at a time.

As a diversified, multi-national organization, youll have access to competitive benefits including a fresh perspective on workplace flexibility.Position Purpose:Promote the quality and cost effectiveness of medical care by applying clinical acumen and the appropriate application of policies and guidelines to emergent/urgent and continued stay reviews.Perform onsite review of emergent/urgent and continued stay requests for appropriate care and setting, following guidelines and policies, and approve services or forward requests to the appropriate Physician or Medical Director with recommendations for other determinationsComplete medical necessity and level of care reviews for requested services using clinical judgment and refer to Medical Directors for review depending on case findingsCollaborate with various staff within provider networks and discharge planning team electronically, telephonically, or onsite to coordinate member careConduct discharge planningEducate providers on utilization and medical management processesProvide clinical knowledge and act as a clinical resource to non-clinical team staffEnter and maintain pertinent clinical information in various medical management systemsOur Comprehensive Benefits Package:Flexible work solutions including remote options, hybrid work schedules and dress flexibilityCompetitive payPaid Time Off including paid holidaysHealth insurance coverage for you and dependents401(k) and stock purchase plansTuition reimbursement and best-in-class training and developmentEducation/Experience: Graduate from an Accredited School of Nursing.

Bachelors degree in Nursing preferred.

2+ years of clinical nursing experience.

Acute care experience preferred Knowledge of healthcare and managed care preferred.Licenses/Certifications: Current states LPN/LVN or RN license.Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.