Clinical Review Nurse - Concurrent Review
Centene Corporation · Worldwide
Utilization Review
Remote/Hybrid — check advert
Nurse
Demand84
Career growth68
Healthcare fit82
Remote potential70
Salary band
USD 27 – 49
5-year outlook
Posted hourly pay is competitive for licensed nurses, with advancement likely tied to utilization-management seniority, payer experience, or leadership roles rather than automatic large salary jumps.
Clinical license
Required
Applicant reach
narrow
Seniority
mid
Employment type
full-time
Date found
2026-10-30
Intelligence details
Flexible work details
- Side income
- Classified as side-income friendly
- Engagement type
- Permanent
- Hours
- Full-time
- Eligible countries
- Worldwide
- 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 licensed nurses with acute care experience who want a non-bedside payer role with utilization review exposure. Less suitable for clinicians without active nursing licensure or those seeking direct patient care.
Who should apply
Acute care RNs or LPNs with 2+ years of bedside experience who are interested in payer utilization management, discharge planning, Medicare/Medicaid, and care coordination.
CV angle
Frame acute-care nursing experience around medical necessity assessment, level-of-care decisions, discharge planning, interdisciplinary communication, and EHR documentation. Add any Medicare/Medicaid, case management, utilization review, or care coordination exposure.
Skills to highlight
- Concurrent review
- Utilization management
- Discharge planning
- Medical necessity criteria
- Medicare/Medicaid knowledge
- Care coordination
- Clinical documentation
- Interdisciplinary collaboration
Role summary
A payer-side nursing role focused on concurrent review of member care, length of stay, discharge planning, and medical necessity determinations in collaboration with providers, care management, and medical directors.
We publish our own intelligence summary, never the full job description. Always confirm details with the employer when you apply.