Clinical Review Nurse - Concurrent Review

The Clinical Review Nurse performs concurrent reviews to assess members' overall health, evaluate the type of care being delivered, and contribute to discharge planning according to care policies and guidelines. This role is ideal for those with experience in acute rehab, SNF, or LTC.

• Pay: $27.02 - $48.55 per hour
• Location: Remote, AZ
• Schedule: Full-time, Day shift (Monday - Friday, 8am - 5pm with rotational weekends and holidays)
• Residency: Must reside in Arizona, Nevada, Oregon, or Washington

• Perform concurrent reviews of members for appropriate care and setting.
• Review quality and continuity of care by assessing acuity level, resource consumption, and discharge planning.
• Work with Medical Affairs and/or Medical Directors to discuss member care.
• Collect, document, and maintain concurrent review findings and discharge plans in health management systems.
• Collaborate with healthcare providers to approve medical determinations or provide recommendations.
• Educate providers on utilization processes to ensure high-quality care.
• Provide feedback to leadership on opportunities to improve care levels and medical necessity.
• Review members’ transfer or discharge plans for timely discharges.
• Collaborate with care management on member referrals.
• Perform other duties as assigned.

• Graduate from an Accredited School of Nursing or Bachelor’s degree in Nursing required.

• 2+ years of acute care experience required.
• 2-4 years of related experience preferred.

• LPN (Licensed Practical Nurse) - State Licensure required
• RN (Registered Nurse) - State Licensure and/or Compact State Licensure for State of Nevada required

• Competitive pay
• Health insurance
• 401K and stock purchase plans
• Tuition reimbursement
• Paid time off plus holidays
• Flexible work schedules (remote, hybrid, field, or office)

Centene is a leading healthcare provider committed to delivering exceptional patient care. They connect people to the care they need to live healthier lives, making a real impact every day through meaningful challenges that support individuals, families, and communities.