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Centene Remote Rn Jobs in Phoenix, AZ (NOW HIRING)

Oscar Health

Utilization Review Nurse

Tempe, AZ · Remote

$35 - $45.94/hr

This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois ... Active, unrestricted RN licensure from the United States in [state], OR, active compact multistate ...

BetterHelp

Licensed Psychologist- Remote

Phoenix, AZ · Remote

$650/wk

Work from the comfort of home (fully remote) * Flexible schedule - you set your own hours. * Free ... Also, we are unable to accept substance abuse counselors, school counselors, registered nurses ...

PRIORITY ONDEMAND

Nurse Practitioner

Phoenix, AZ · Remote

This fully remote role supports readmission avoidance, care continuity, and patient stabilization ... Registered with AHCCCS preferred • Experience with chronic conditions and care management ...

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Centene Remote Rn information

See Phoenix, AZ salary details

$954

$1.9K

$3K

How much do centene remote rn jobs pay per week?

As of Jul 18, 2026, the average weekly pay for centene remote rn in Phoenix, AZ is $1,942.23, according to ZipRecruiter salary data. Most workers in this role earn between $1,517.31 and $2,273.08 per week, depending on experience, location, and employer.

Does Centene offer remote work?

Centene offers remote work opportunities for many of its roles, including remote registered nurse (RN) positions. These jobs typically require strong communication skills, relevant certifications, and the ability to work independently in a virtual environment.

Is it hard to get hired by Centene?

Getting hired as a remote RN at Centene can be competitive, as the company values relevant nursing experience, certifications, and strong communication skills. Candidates often undergo multiple interview stages and background checks, and having familiarity with healthcare software and telehealth tools can improve chances of selection.

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 qualifications are needed for Centene remote jobs?

Centene remote RNs typically need a valid nursing license, such as a state-specific RN license, and relevant clinical experience. Additional requirements may include strong communication skills, computer proficiency, and the ability to work independently in a virtual environment.

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.

Is Centene a good company to work for remotely?

Centene offers remote RN positions that typically include flexible schedules and the use of telehealth technology. The company is known for providing benefits and support for remote employees, making it a viable option for nurses seeking remote work. However, individual experiences may vary based on role and location.

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 Phoenix, AZ? For Centene Remote Rn jobs in Phoenix, AZ, the most frequently searched job titles are:
What job categories do people searching Centene Remote Rn jobs in Phoenix, AZ look for? The top searched job categories for Centene Remote Rn jobs in Phoenix, AZ are:
Centene Remote Rn jobs near you
Infographic showing various Centene Remote Rn job openings in Phoenix, AZ as of July 2026, with employment types broken down into 88% Full Time, 6% Part Time, and 6% Contract. Highlights an 100% Remote job distribution, with an average salary of $100,996 per year, or $48.6 per hour.
Medical Appeals and Grievance (MAG) Registered Nurse Specialist II - Remote

Medical Appeals and Grievance (MAG) Registered Nurse Specialist II - Remote

Blue Cross Blue Shield of Arizona

Phoenix, AZ • On-site, Remote

Full-time

Medical

Posted 26 days ago

Blue Cross Blue Shield Of Arizona rating

5.9

Company rating: 5.9 out of 10

Based on 13 frontline employees who took The Breakroom Quiz

263rd of 281 rated insurance

Job description

Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.
At AZ Blue, we have a hybrid workforce strategy, called Workability, that offers flexibility with how and where employees work. Our positions are classified as hybrid, onsite or remote. While the majority of our employees are hybrid, the following classifications drive our current minimum onsite requirements:
  • Hybrid People Leaders: must reside in AZ, required to be onsite at least twice per week
  • Hybrid Individual Contributors: must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per week
  • Hybrid 2 (Operational Roles such as but not limited to: Customer Service, Claims Processors, and Correspondence positions): must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per month
  • Onsite: daily onsite requirement based on the essential functions of the job
  • Remote: not held to onsite requirements, however, leadership can request presence onsite for business reasons including but not limited to staff meetings, one-on-ones, training, and team building

Please note that onsite requirements may change in the future, based on business need, and job responsibilities. Most employees should expect onsite requirements and at a minimum of once per week.
This position is remote within Arizona or in an approved out-of-state location. Applicants must reside in-and perform work from-the state of Arizona or an approved out-of-state location.
Purpose of the job
Responsible for utilizing clinical acumen and managed care expertise related to researching, resolving and responding to requests for member and provider appeals, grievances, reconsiderations and corrected claims for all lines of business with emphasis on privacy, accuracy, meeting all regulatory and compliance timelines.
Qualifications
REQUIRED QUALIFICATIONS
Required Work Experience
Level 1
  • 1 year Experience in clinical and health insurance or other healthcare related field

Level 2
  • 3 years' Experience in clinical and health insurance or other healthcare related field
  • 1 year' Managed care experience with a focus in Utilization Management (UM), Prior Authorization (PA), Claims, Case Management and/or Medical Appeals and Grievance (MAG)

Level 3
  • 5 years' Experience in clinical and health insurance or other healthcare related field
  • 2 years Managed care experience with a focus in Utilization Management (UM), Prior Authorization (PA), Claims, Case Management and/or Medical Appeals and Grievance (MAG)

Level 4
  • 8 years' Experience in clinical and health insurance or other healthcare related field
  • 3 years' Above satisfactory job performance in the managed care environment with a focus in Utilization Management (UM), Prior Authorization (PA), Claims, Case Management and/or Medical Appeals and Grievance (MAG)

Required Education
  • Associate's Degree in a healthcare field of study or Nursing Diploma (Applies to All Levels)

Required Licenses
  • Active, current, and unrestricted license to practice in the State of Arizona (a state in the United States) or a compact state as a Registered Nurse (RN)

Required Certifications
  • N/A

PREFERRED QUALIFICATIONS
Preferred Work Experience
Level 1
  • 3 years' Experience in clinical and health insurance or other healthcare related field. Working knowledge of eviCore, MCG, McKesson InterQual® criteria and Medical Coverage Guidelines/Medical Policies. Advanced ability to interpret contract language and benefits

Level 2
  • 5 years' Experience in clinical and health insurance or other healthcare related field. Working knowledge of eviCore, MCG, McKesson InterQual® criteria and Medical Coverage Guidelines/Medical Policies. Advanced ability to interpret contract language and benefits
  • 2 years' Managed care experience with a focus in Utilization Management (UM), Prior Authorization (PA), Claims, Case Management and/or Medical Appeals and Grievance (MAG)

Level 3
  • 7 years' Experience in clinical and health insurance or other healthcare related field. Working knowledge of eviCore, MCG, McKesson InterQual® criteria and Medical Coverage Guidelines/Medical Policies. Advanced ability to interpret contract language and benefits
  • 5 years' Managed care experience with a focus in Utilization Management (UM), Prior Authorization (PA), Claims, Case Management and/or Medical Appeals and Grievance (MAG)

Level 4
  • 9 years' Experience in clinical and health insurance or other healthcare related field. Working knowledge of eviCore, MCG, McKesson InterQual® criteria and Medical Coverage Guidelines/Medical Policies. Advanced ability to interpret contract language and benefits
  • 5 years' Above satisfactory job performance in the managed care environment with a focus in Utilization Management (UM), Prior Authorization (PA), Claims, Case Management and/or Medical Appeals and Grievance (MAG)

Preferred Education
  • Bachelor's Degree in Nursing or related field of study (Applies to All Levels)

Preferred Licenses
  • N/A

Preferred Certifications
  • N/A

ESSENTIAL job functions AND RESPONSIBILITIES
Level I
  • Perform in-depth analysis, clinical review and resolution of provider appeals/inquiries, corrected claims and subscriber reconsiderations, member appeals, corrected claims and provider grievances for all lines of business
  • Identify, research, process, resolve and respond to customer inquiries primarily through written / verbal communication.
  • Respond to a diverse and high volume of health insurance appeal related correspondence on a daily basis.
  • Analyze medical records and apply medical necessity criteria and benefit plan requirements to determine the appropriateness of appeal, grievance and reconsideration requests.
  • Maintain complete and accurate records per department policy.
  • Meet quality, quantity and timeliness standards to achieve individual and department performance goals as defined within the department guidelines and required by State, Federal and other accrediting organizations.
  • Demonstrate ability to apply plan policies and procedures effectively.
  • Consult and coordinate with various internal departments, external plans, providers, businesses, and government agencies to obtain information and ensure resolution of customer inquiries.
  • Attend staff and interdepartmental meetings.
  • Participate in continuing education and current developments in the fields of medicine and managed care.
  • Maintain all standards in consideration of State, Federal, BCBSAZ and other accreditation requirements.
  • Maintain productivity and accuracy goals based on regulatory requirements, accreditation standards, and service level agreements.
  • Demonstrate ability to acquire specialized knowledge to complete all types of level one appeals, grievances and corrected claims for local lines of business using appropriate benefit plan booklet, administrative guidelines and policies, medical criteria guidelines, claims research, provider contracts and fee schedules, communication records research and precertification research.
  • Articulate to customers a variety of information about the organization's services, including but not limited to, contract benefits, changes in coverage, eligibility, claims, BCBSAZ programs, and provider networks.
  • Adheres to BCBSAZ brand promise of being a "Trusted Advisor" by walking in the customers shoes including processing work using the principles of easy, effective, emotional

level II
  • Ability to demonstrate specialized knowledge to administer Federal Employee Program (FEP)inquiries, appeals, grievances and sub-reconsiderations using appropriate service benefit plan provisions, and internal policies, medical criteria guidelines, claims research, provider contracts and fee schedules, communication records research, and precertification research.
  • Ability to demonstrate specialized knowledge to perform reviews for local lines of business, Blue Card Home member appeals and grievances, and Blue Card Host provider grievances. MAG Clinicians also support FEP for member reconsiderations, provider appeals, corrected claims and inquiries.

level III
  • Ability to demonstrate specialized knowledge to complete all Levels of Medical Appeals and Grievance (MAG) cases (Initial internal, voluntary internal and external review appeals and grievances).
  • Under minimal direction, lead interdepartmental meetings and oversee special projects as assigned.
  • Assist in developing new policies and procedures, desk levels, and job aids as needed.
  • Assist in training new staff and provide ongoing training for existing staff as needed.
  • Assist in distribution of staff Flow Manager case assignments.
  • Identify and recommend process improvements.

level IV
  • Assist in distribution of staff case assignments.
  • Under minimal direction, prepare reports and documentation for committee presentation and ad hoc reports as needed.
  • Analyze appeals and grievances data and make recommendations based on trends identified.
  • Take initiative to follow through on issues and opportunities for process improvements.
  • Initiate, develop and implement in-service educational presentations.
  • Work collaboratively with management and provide leadership for the department in day to day activities as well as in management's absence.
  • Maintain a working knowledge of all activities in the department and provide assistance to departmental staff and interdepartmental staff as necessary.
  • Consistently demonstrate alignment with the BCBSAZ "Living our Values" culture by participating in annual, community service campaigns and/or projects such as, CARES Club, United Way and/or community wellness initiatives (Walk for Hope, Walk to Stop Diabetes, Phoenix Heart Walk, etc).

ALL LEVELS
  • Each progressive level includes the ability to perform the essential functions of any lower levels.
  • The position requires a full-time work schedule. Full-time is defined as working at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirements.
  • Perform all other duties as assigned

competencies
REQUIRED COMPETENCIES
Required Job Skills
  • Intermediate PC proficiency (All Levels)
  • Intermediate skill using office equipment, including copiers, fax machines, scanner and telephones (All Levels)

Required Professional Competencies
  • Maintain confidentiality and privacy
  • Advanced clinical knowledge
  • Practice interpersonal and active listening skills to achieve customer satisfaction
  • Compose a variety of business correspondence
  • Interpret and translate policies, procedures, programs and guidelines
  • Capable of investigative and analytical research
  • Navigate, gather, input and maintain data records in multiple system applications
  • Follow and accept instruction and direction
  • Establish and maintain working relationships in a collaborative team environment
  • Organizational skills with the ability to prioritize tasks and work with multiple priorities under limited time constraints
  • Independent and sound judgment with good problem solving skills
  • Ability to assist in training of new and existing staff (Applies to Levels 3 and 4)

Required Leadership Experience and Competencies
  • Ability to revise departmental policies and procedures and desk levels as well as develop new policies and procedures and desk levels as needed (Applies to Levels 3 and 4)
  • Proven leadership and assistance through positive reinforcement of processes and company policies
    (Applies to Levels 3 and 4.)

PREFERRED COMPETENCIES
Preferred Job Skills
  • Advanced PC proficiency
  • Knowledge of Current CPT, ICD- 9, ICD-10, HCPCS, and DRG coding

Preferred Professional Competencies
  • Working knowledge of McKesson InterQual® criteria and Medical Coverage Guidelines/Medical Policies
  • Advanced ability to interpret contract language and benefits

Preferred Leadership Experience and Competencies
  • N/A

Our Commitment
AZ Blue does not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected group.
Thank you for your interest in Blue Cross Blue Shield of Arizona. For more information on our company, see azblue.com. If interested in this position, please apply.

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