Clinical Review Nurse - Prior Authorization (Hospice)
Centene Corporation · United States · US
Utilization Review
Remote/Hybrid — check advert
Nurse
Demand82
Career growth68
Healthcare fit85
Remote potential70
5-year outlook
Stable payer-side utilization review demand is likely, with compensation growth tied to RN licensure, managed care/UM experience, and hospice expertise. Exact salary varies by state, employer, and full-time/part-time status.
Clinical license
Required
Applicant reach
moderate
Seniority
mid
Employment type
full-time
Date found
2026-10-24
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
Worth considering for licensed nurses who want a payer-side, non-bedside role with predictable utilization review work. Less suitable for clinicians without active licensure or prior authorization/UM exposure.
Who should apply
LPNs and RNs with hospice, managed care, utilization review, case management, or prior authorization experience; nurses seeking remote/hybrid payer roles and reduced direct patient care.
CV angle
Frame bedside or hospice nursing experience around medical necessity documentation, care coordination, discharge/transition planning, regulatory compliance, and provider communication. Use payer language such as prior authorization, utilization management, Medicare/Medicaid criteria, and clinical review, but do not claim UM experience you do not have.
Skills to highlight
- Medical necessity review
- Prior authorization
- Utilization management
- Hospice/end-of-life care
- Care coordination
- Discharge/transition planning
- Medicare/Medicaid regulations
- Clinical documentation
- Provider communication
Role summary
Payer-side nursing role reviewing prior authorization requests for medical necessity, coordinating with providers and medical directors, documenting clinical information, and supporting timely hospice and transition-of-care authorizations.
We publish our own intelligence summary, never the full job description. Always confirm details with the employer when you apply.