Clinical Review Nurse-Concurrent Review
Centene Corporation · United States · US
Utilization Review
Remote/Hybrid — check advert
Nurse
Demand82
Career growth68
Healthcare fit88
Remote potential78
5-year outlook
Payer-side utilization review nursing roles tend to offer stable compensation with moderate growth into senior review, audit, or managed-care leadership; exact pay depends on licensure, location, 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
- Eligible countries
- United States
- License jurisdiction
- US
- 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
A strong option for nurses with acute care experience who want a non-bedside, payer-side role with predictable workflows and remote/hybrid potential. The main barriers are active licensure and the 2+ year acute care requirement.
Who should apply
RNs or LPNs with 2+ years of acute care experience, especially those interested in utilization management, managed care, Medicare/Medicaid, discharge planning, or care coordination.
CV angle
Frame acute care experience around medical necessity, level-of-care determination, discharge planning, interdisciplinary collaboration, payer communication, and documentation in EHR/health management systems. Highlight any Medicare/Medicaid, utilization review, or care management exposure without overstating it.
Skills to highlight
- Utilization management
- Concurrent review
- Discharge planning
- Medical necessity determination
- Care coordination
- Medicare/Medicaid knowledge
- Clinical documentation
- Provider communication
Role summary
A nurse reviewer role at Centene performing concurrent utilization review, assessing medical necessity and appropriate level of care, coordinating discharge planning, and collaborating with providers and medical directors.
We publish our own intelligence summary, never the full job description. Always confirm details with the employer when you apply.