RN Clinical Appeals Coordinator at Centene

This role is designed for an experienced Registered Nurse (RN) or Licensed Practical Nurse (LPN) who thrives at the intersection of clinical care and administrative strategy. The ideal candidate has at least 4-5 years of clinical experience and a sharp eye for detail, specifically regarding medical necessity and regulatory compliance. Since this position act as a bridge between members, providers, and state agencies, it requires someone who is comfortable navigating complex legal and NCQA standards. A major highlight of this position is the full remote flexibility, though you **must** be a resident of Louisiana to qualify. The pay scale is broad, allowing for significant upward mobility based on your seniority and expertise. In addition to a competitive hourly rate, the package includes comprehensive corporate benefits like a stock purchase plan, tuition reimbursement, and holiday pay. **You might be a good fit if you...** * Hold an active RN, LPN, or LVN license and live in Louisiana. * Have a background in Managed Care, Utilization Review, or Case Management. * Enjoy "investigative" work—reviewing clinical records to justify medical necessity. * Are skilled at drafting formal, compliant professional correspondence for state hearings.