Clinical Review Nurse - Correspondence at Centene

You're a licensed practical nurse with 2-4 years of experience in nursing, preferably with a background in prior authorization, concurrent review, or utilization review. **What makes it worth a look...** Centene is hiring a full-time Clinical Review Nurse for their Medical Management team, offering $27.02 - $48.55 per hour. This is a fully remote role for candidates residing in the Central or Eastern time zones. **You might be a good fit if you...** * Have graduated from an accredited school of nursing or hold a Bachelor’s degree in Nursing. * Can draft and edit denial letters based on review outcomes and NCQA standards. * Are familiar with Medicare and Medicaid regulations, and utilization management processes. * Can investigate denials by reviewing clinical documentation, criteria, and policy.