Centene Management Company LLC is seeking an experienced RN/LPN/LVN to act as liaison for statewide appeals and fair hearings. You will review clinical data to assess medical necessity and prepare compliant response letters for members and providers.
The role requires coordinating with Medical Directors and maintaining thorough appeal files, with emphasis on NCQA and state regulations. Experience in utilization management or managed care is preferred.
#J-18808-LjbffrRemote Clinical Appeals & Utilization Coordinator in workfromhome at Unknown Company
This position is listed as full time and onsite.