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Centene Remote Rn Jobs in North Carolina (NOW HIRING)

Sagility LLC

RN Utilization Management Reviewer

Concord, NC · Remote

$35 - $40/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Job title: RN Utilization Management Reviewer We are currently hiring a talented RN, Utilization ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...

Sagility

RN Utilization Management Reviewer

Concord, NC · Remote

$35 - $40/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Job title: RN Utilization Management Reviewer We are currently hiring a talented RN, Utilization ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...

Sagility

RN Utilization Management Reviewer

Concord, NC · Remote

$35 - $40/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Job title: RN Utilization Management Reviewer We are currently hiring a talented RN, Utilization ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...

Oshi Health

GI- Nurse Practitioner

Charlotte, NC · Remote

Preferred RN compact License Required Location: We are only hiring from the following states ... Remote-first -- work from home anywhere in the US within our approved states * Growth: Advanced ...

SalvoHealth

Registered Dietitian, Remote

Charlotte, NC · On-site +1

$30.50 - $41/hr

  • Medical

  • Dental

  • Vision

  • PTO

... Remote Patient Monitoring ("RPM") to bill under the patient's insurance. This is a major step ... Work closely with a multidisciplinary team, including fellow registered dietitians, licensed nurses ...

SalvoHealth

Registered Dietitian, Remote

Charlotte, NC · Remote

$30.50 - $41/hr

  • Medical

  • Dental

  • Vision

  • PTO

... Remote Patient Monitoring ("RPM") to bill under the patient's insurance. This is a major step ... Work closely with a multidisciplinary team, including fellow registered dietitians, licensed nurses ...

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All JobsCentene Rn JobsCentene Remote Rn JobsCentene Remote Rn Jobs in North Carolina

Centene Remote Rn information

Does Centene allow remote work?

Centene offers remote work opportunities for certain positions, including roles like registered nurses (RNs). Remote RN positions typically require relevant licensure, strong communication skills, and the ability to work independently in a virtual environment.

What is the difference between Centene Remote Rn vs Centene Remote Lpn?

AspectCentene Remote RnCentene Remote Lpn
Required CredentialsRegistered Nurse (RN) licenseLicensed Practical Nurse (LPN) license
Work EnvironmentRemote healthcare setting, patient assessments, care planningRemote healthcare setting, basic patient care, documentation
Employer & Industry UsageMajor healthcare provider, insurance industry

The main difference between Centene Remote Rn and Centene Remote Lpn lies in the required credentials and scope of practice. RNs typically handle more complex patient assessments and care planning, while LPNs focus on basic patient care and documentation. Both roles are remote and serve within the healthcare and insurance industry, but RNs generally have a broader scope of practice and higher responsibilities.

What is a Centene Remote RN?

A Centene Remote RN is a registered nurse who works for Centene Corporation, a large managed care company, primarily from a remote or home-based setting. These nurses provide care coordination, case management, health assessments, and support to members over the phone or via digital platforms rather than in-person. Their responsibilities often include educating patients, monitoring health conditions, and collaborating with healthcare providers to ensure members receive appropriate care. This role allows for flexibility and the opportunity to support patients across different locations.

What does a typical workday look like for a Centene Remote RN, and how does remote nursing differ from traditional bedside roles?

As a Centene Remote RN, your day typically involves conducting telephonic or virtual assessments, coordinating care plans, and collaborating with multidisciplinary teams to support members’ health needs. Unlike traditional bedside roles, remote nursing emphasizes case management, patient education, and ongoing follow-up rather than direct clinical procedures. You'll use electronic health records and communication platforms extensively, so strong organizational and communication skills are essential. The remote environment offers greater autonomy and flexibility but also requires proactive engagement to maintain effective teamwork and patient outcomes.

What are the key skills and qualifications needed to thrive as a Centene Remote RN, and why are they important?

To thrive as a Centene Remote RN, you need a current RN license, clinical experience (often in case management or utilization review), and a strong understanding of healthcare regulations. Familiarity with care management software, telehealth platforms, and Centene-specific systems is typically required. Excellent communication, self-motivation, and strong organizational skills are essential soft skills for remote collaboration and effective patient engagement. These skills are crucial for ensuring quality care coordination, regulatory compliance, and seamless communication in a virtual healthcare environment.

What are popular job titles related to Centene Remote Rn jobs in North Carolina?

For Centene Remote Rn jobs in North Carolina, the most frequently searched job titles are:

What job categories do people searching Centene Remote Rn jobs in North Carolina look for?

The top searched job categories for Centene Remote Rn jobs in North Carolina are:

Centene Remote Rn jobs near you
Infographic showing various Centene Remote Rn job openings in North Carolina as of August 2026, with employment types broken down into 85% Full Time, 10% Part Time, and 5% Contract. Highlights an 100% Remote job distribution.

RN Utilization Management Reviewer

Sagility LLC

Concord, NC • Remote

$35 - $40/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 5 days ago

Sagility rating

4.6

Company rating: 4.6 out of 10

Based on 29 frontline employees who took The Breakroom Quiz

62nd of 71 rated call and contact centers

Job description

Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries.

Job title:

RN Utilization Management Reviewer

Job Description:

We are currently hiring a talented RN, Utilization Management Reviewer. This role will be responsible in day-to-day timely clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring the client meets CMS compliance standards in the area of service decisions and organizational determinations. Successful candidates must hold a valid, current license issued by the Massachusetts Board of Registration in Nursing.

Key responsibilities:

  • Conducts timely clinical decision review for services requiring prior authorization in a variety of clinical areas, including but not limited to surgical procedures, Medicare Part B medications, Long Term Services and Supports (LTSS), and Home Health (HH)
  • Applies established criteria (e.g., InterQual and other available guidelines) and employs clinical expertise to interpret clinical criteria to determine medical necessity of services
  • Communicates results of reviews verbally, in the medical record, and through official written notification to the primary care team, specialty providers, vendors and members in adherence with regulatory and contractual requirements
  • Provides decision-making guidance to clinical teams on service planning as needed
  • Works closely with Clinicians, Medical Staff and Peer Reviewers to facilitate escalated reviews in accordance with Standard Operating Procedures
  • Ensures accurate documentation of clinical decisions and works with UM Manager to ensure consistency in applying policy
  • Works with UM Manager and other clinical leadership to ensure that departmental and organizational policies and procedures as well as regulatory and contractual requirements are met
  • Additional duties as requested by supervisor
  • Maintains knowledge of CMS, State and NCQA regulatory requirements

Education Requirements:

  • RN - Associate's Degree required, Bachelor's Degree preferred
  • RN, current license issued by the Massachusetts Board of Registration in Nursing
  • CCM (Certified Case Manager) a plus

Required Experience (must have):

  • 1 to 2 years Utilization Management experience.
  • 2 or more years working in a clinical setting

Desired Experience (nice to have):

  • 2 or more years of Home Health Care experience
  • 2 or more years working in a Medicare Advantage health Plan

Required Knowledge, Skills & Abilities (must have):

  • Ability to complete assigned work in a timely and accurate manner
  • Knowledge of the Utilization management process
  • Ability to work independently

Desired Knowledge, Skills, Abilities & Language (nice to have):

  • Ability to apply predetermined criteria (e.g., Medical Necessity Guidelines, InterQual) to service decision requests to assess medical necessity
  • Flexibility and understanding of individualized care plans
  • Ability to influence decision making
  • Strong collaboration and negotiation skills
  • Strong interpersonal, verbal, and written communication skills
  • Comfort working in a team-based environment
  • Knowledge of Medicare and Mass health services and benefits

Salary: $35.00 - $40.00 Hourly pending experience.

Hours: Monday through Friday 9AM to 5:30PM Eastern Time. May require weekends

This is a fully remote work at home role. You must have a secure, private wok at home area with a hardwired internet connection with speeds greater than 5MB upload and 10MB download.

Sagility Offers Competitive Benefits Including:

  • Medical
  • Dental
  • Vision
  • Life Insurance
  • Short-Term and Long-Term Disability
  • Flexible Spending Account
  • Life Assistance Program
  • 401K with employer contribution
  • PTO and Sick Time
  • Tuition Reimbursement

Join our team, we look forward to talking with you!

An Equal Opportunity Employer/Vet/Disability

Location:

Work@Home USAUnited States of America

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