Clinical Review Nurse-Prior Authorization

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.
 

Centene is hiring a Remote Clinical Review Nurse – Prior Authorization to support our Duals team .

The ideal candidate will have experience reviewing outpatient services , with a background in one or more of the following areas:

• Imaging services

• Durable Medical Equipment (DME)

• Home Health Care

• Elective inpatient services

This role is responsible for conducting clinical reviews for prior authorization requests in accordance with medical necessity guidelines, regulatory requirements, and company policies.

This is a remote position with standard business hours, Monday t...