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Home Based Centene Rn Jobs in Oregon (NOW HIRING)

Centene

Clinical Review Nurse - Concurrent Review

OR · Remote

$27.02 - $48.55/hr

Centene is a diversified, national organization offering competitive benefits including a fresh ... Works with healthcare providers to approve medical determinations or provide recommendations based ...

IntelyCare

RN Home Health Weekend

Baker City, OR

As a national leader in home-based care, Enhabit is consistently ranked as one of the best places ... The Home Health Weekend Registered Nurse is a field employee who: * Performs skilled nursing visits ...

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Home Based Centene Rn information

Does Centene give you a laptop?

Home Based Centene RNs are typically provided with necessary equipment, including laptops or computers, to perform their remote duties. The company supplies or reimburses for technology needed to ensure effective telehealth services and documentation. Specific provisions may vary based on the role and location, so it is advisable to confirm with the hiring manager or HR representative.

What is the difference between Home Based Centene Rn vs Home Health Nurse?

AspectHome Based Centene RnHome Health Nurse
CertificationsRN license, possibly case management certificationRN license, often case management or hospice certification
Work EnvironmentPrimarily remote, working with insurance and case management teamsPrimarily in patients' homes, providing direct care
Employer & IndustryCentene Corporation, healthcare insurance industryHome health agencies, healthcare services industry

Both roles require an RN license and involve patient care, but the Home Based Centene Rn focuses on case management and insurance coordination remotely, while the Home Health Nurse provides direct patient care in home settings. The choice depends on whether you prefer remote administrative work or hands-on nursing in patients' homes.

What cities in Oregon are hiring for Home Based Centene Rn jobs? Cities in Oregon with the most Home Based Centene Rn job openings:
Home Based Centene Rn jobs near you
Clinical Review Nurse - Concurrent Review

Clinical Review Nurse - Concurrent Review

Centene

Remote

$27.02 - $48.55/hr

Full-time

Medical, Retirement, PTO

Posted 15 days ago

Centene rating

8.4

Company rating: 8.4 out of 10

Based on 382 frontline employees who took The Breakroom Quiz

31st of 864 rated healthcare providers

Job description

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.

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.

This is a 100% remote position that supports out Health Plan in Oregon, must have or willing to obtain an OR License. Prefer candidate to reside in Central, Mountain or Pacific Time Zones.

  • Performs concurrent reviews of member for appropriate care and setting to determine overall health and appropriate level of care
  • Reviews quality and continuity of care by reviewing acuity level, resource consumption, length of stay, and discharge planning of member
  • Works with Medical Affairs and/or Medical Directors as needed to discuss member care being delivered
  • Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member medical records in health management systems according to utilization management policies and guidelines
  • Works with healthcare providers to approve medical determinations or provide recommendations based on requested services and concurrent review findings
  • Assists with providing education to providers on utilization processes to ensure high quality appropriate care to members
  • Provides feedback to leadership on opportunities to improve appropriate level of care and medically necessity based on clinical policies and guidelines
  • Reviews member's transfer or discharge plans to ensure a timely discharge between levels of care and facilities
  • Collaborates with care management on referral of members as appropriate
  • Performs other duties as assigned.
  • Complies with all policies and standards.

Education/Experience: Requires Graduate from an Accredited School of Nursing or Bachelor's degree in Nursing and 2 - 4 years of related experience. 2+ years of acute care experience required.
Clinical knowledge and ability to determine overall health of member including treatment needs and appropriate level of care preferred.
Knowledge of Medicare and Medicaid regulations preferred.
Knowledge of utilization management processes preferred.
License/Certification:

  • LPN - Licensed Practical Nurse - State Licensure required
  • RN - Registered Nurse - State Licensure and/or Compact State Licensure For State of Nevada required
Pay Range: $27.02 - $48.55 per hour

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.


Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

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