Clinical Review Nurse-Concurrent Review

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.

*****Applicants must have and maintain active New York State (NYS) RN licensure to be considered. The standard fully remote work schedule is Monday through Friday, 8:30 a.m. to 5:00 p.m. EST with coverage also on 1 of 2 holidays; the day after Thanksgiving or Christmas Eve as assigned.*****

**Position Purpose:** Performs concurrent reviews, including determining member's overall health, reviewing the type of care being delivered, evaluating medical necessity, and contributing to discharge planning according to care policies and guidelines. Assists evaluating inpatient services to validate the necessity and setting of care being delivered to the member.

+ Performs concurrent reviews o...