Centene Corporation

The Clinical Review Nurse position supports the Medical Management and Health Services team at Centene, a national healthcare organization. This remote role requires working Eastern or Central Standard Time and involves performing concurrent reviews to assess member health, evaluate medical necessity, and determine appropriate levels of care. Key responsibilities include collaborating with medical directors and healthcare providers to validate inpatient services, assisting with discharge planning, and educating providers on utilization processes. The position demands strong clinical knowledge and experience in acute care and utilization management. The role is appealing due to its impact on the health outcomes of millions of members, offering a fresh perspective on workplace flexibility and a supportive, diverse work environment. Candidates must hold a valid state nursing license and possess relevant experience in clinical review and care coordination. View more