Senior RN Clinical Review Nurse - Prior Authorization at Centene Corporation is a remote clinical nursing role for experienced RNs ready to impact healthcare at scale. You'll earn $70k–$90k/yr while supporting prior authorization decisions for 28 million members nationwide — competitive pay, full benefits, and the stability of a Fortune 500 healthcare leader.
Your day involves reviewing clinical documentation and medical records to determine coverage eligibility, applying clinical judgment to assess medical necessity against plan guidelines, collaborating with providers and case managers to resolve authorization requests, researching clinical evidence and policy updates to inform decisions, and documenting all reviews thoroughly to maintain compliance and audit trails.
You need an active RN license and at least 3–5 years of clinical nursing experience; healthcare IT or prior authorization background is a strong plus but not required. No additional degree beyond your RN is needed — your license and experience are what matter.
