Clinical Review Nurse - Concurrent Review
Centene Corporation · Azerbaijan
Utilization Review
Remote/Hybrid — check advert
Nurse
Demand78
Career growth62
Healthcare fit84
Remote potential85
Salary band
USD 27 – 49
5-year outlook
Utilization review nursing pay is generally stable and competitive with bedside nursing, with the posted range ($27.02-$48.55/hr) reflecting experience and geography. Growth typically comes from moving into senior UM, appeals, or managed care leadership rather than large in-role raises.
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
- Hourly
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
Worth applying for nurses with acute care, rehab, SNF, or LTC backgrounds who want to leave the bedside and move into payer-side utilization management. The remote/hybrid flexibility and structured weekday schedule are strong draws, but be prepared for multi-state licensure and rotational weekend coverage.
Who should apply
RNs and LPNs with 2+ years of acute care, acute rehab, SNF, or long-term care experience who want a non-bedside, remote-friendly role; nurses with prior utilization management, discharge planning, or care coordination exposure; nurses willing to obtain or already holding compact/multi-state licensure.
CV angle
Reframe bedside acute care experience around utilization-relevant competencies: discharge planning, level-of-care determination, interdisciplinary collaboration with providers and case management, clinical documentation, and application of evidence-based guidelines. Quantify caseloads, length-of-stay management, and coordination with payers or post-acute facilities where possible, and explicitly list Medicare/Medicaid familiarity and any UM or InterQual/Milliman exposure.
Skills to highlight
- Concurrent review / utilization management
- Discharge planning and care transitions
- Medical necessity and level-of-care determination
- Acute care, rehab, SNF, or LTC clinical experience
- Medicare and Medicaid regulatory knowledge
- Interdisciplinary collaboration with providers and Medical Directors
- Clinical documentation in health management systems
- Care management referral and coordination
Role summary
A remote/hybrid payer-side utilization review nursing role at Centene supporting Marketplace/Ambetter members across AZ, NV, OR, and WA. The nurse performs concurrent reviews of inpatient members to determine appropriate level of care, reviews acuity, resource use, length of stay, and discharge planning, collaborates with Medical Affairs/Directors and providers, and documents findings in health management systems.
We publish our own intelligence summary, never the full job description. Always confirm details with the employer when you apply.