You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
Position Purpose:
Review medical necessity grievances, including reviewing clinical information to determine if there was a quality of care or substandard care provided.
Education/Experience:
RN with 2+ years of clinical nursing experience. Proficient with Microsoft Office applications. Experience with utilization or appeals review preferred. Knowledge of InterQual criteria preferred.
License/Certification:
Current CA RN license required.Benefits
Our Comprehensive Benefits Package:
Flexible work solutions including remote options, hybrid work schedules and dress flexibility
Envolve Pharmacy Solutions
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United States
Healthcare - Nursing
(No Timezone Provided)
You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
Position Purpose:
Review medical necessity grievances, including reviewing clinical information to determine if there was a quality of care or substandard care provided.
Education/Experience:
RN with 2+ years of clinical nursing experience. Proficient with Microsoft Office applications. Experience with utilization or appeals review preferred. Knowledge of InterQual criteria preferred.
License/Certification:
Current CA RN license required.Benefits
Our Comprehensive Benefits Package:
Flexible work solutions including remote options, hybrid work schedules and dress flexibility