Clinical Review Nurse-Concurrent Review
Centene Corporation · Nicaragua
Utilization Review
Remote/Hybrid — check advert
Nurse
Demand82
Career growth68
Healthcare fit84
Remote potential80
5-year outlook
Payer-side utilization review nursing roles typically offer stable compensation and benefits, with growth into senior review, quality, or managed care leadership. Exact salary depends on licensure, state, and experience.
Clinical license
Required
Applicant reach
moderate
Seniority
mid
Employment type
full-time
Date found
2026-10-03
Intelligence details
Flexible work details
- Side income
- Classified as side-income friendly
- Engagement type
- Permanent
- Hours
- Full-time
- Profession fit
- Nurse
- Rate period
- Annual
Why this was classified this way
- part-time
Listing via Himalayas.
Eligibility, licensing, and location restrictions can change. Always confirm details on the source posting before applying.
Why this is worth applying to
Strong option for nurses with acute care experience who want a payer-side, non-bedside role with remote/hybrid flexibility, though weekend and holiday coverage is required.
Who should apply
RNs or LPNs with 2+ years acute care experience, especially those interested in utilization management, managed care, Medicaid/Medicare, or remote payer roles.
CV angle
Frame acute care experience around clinical assessment, level-of-care determination, discharge planning, interdisciplinary collaboration, documentation, and resource utilization. Add any exposure to Medicare/Medicaid, utilization review, or care coordination.
Skills to highlight
- Utilization management
- Concurrent review
- Medical necessity determination
- Discharge planning
- Medicaid and Medicare regulations
- Clinical documentation
- Care coordination
- Provider communication
Role summary
A payer-side clinical review nurse role at Centene performing concurrent inpatient Medicaid reviews to assess appropriate level of care, medical necessity, length of stay, and discharge planning. Collaborates with Medical Affairs, providers, and care management while documenting in health management systems.
We publish our own intelligence summary, never the full job description. Always confirm details with the employer when you apply.