Clinical Review Nurse - Concurrent Review
Centene CorporationCanada only
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Position Purpose: Performs concurrent reviews, including determining member's overall health, reviewing the type of care being delivered, evaluating medical necessity, and contributing to discharge planning according to care policies and guidelines. Assists evaluating inpatient services to validate the necessity and setting of care being delivered to the member.
Key Details: This is a remote position. The required schedule is Monday- Friday 8:00 am-5:00 pm Pacific Standard Time (PST) and also includes a regular weekend and holiday rotation. Must hold an active RN license in California.
- Performs concurrent reviews of member for appropriate care and setting to determine overall health and appropriate level of care