Clinical Review Nurse - Prior Authorization

About the Role

Centene seeks a Clinical Review Nurse to analyze prior authorization requests remotely. This role ensures medical necessity and appropriate care levels for members.

Key Responsibilities

• Review authorization requests for medical necessity.
• Collaborate with providers and medical teams.
• Assist with discharge planning and documentation.
• Educate providers on utilization processes.

Requirements

• Graduate of accredited nursing school.
• LPN license required.
• 2-4 years clinical experience preferred.
• Knowledge of Medicare/Medicaid regulations preferred.

Benefits & Compensation

• Hourly pay $27.02 to $48.55.
• Health insurance, 401K, tuition reimbursement.
• Paid time off and holidays.

Work Schedule

• Remote position.
• Schedule details not specified.

This role offers a flexible remote work environment with competitive pay and benefits. Join a national leader in healthcare management.