To support the Medical Management/Health Services team, the full-time Registered Nurse Clinician Specialist will provide clinical and operational support, develop clinical policies, and ensure compliance with regulatory standards while working remotely. Key responsibilities: • Draft and update clinical guidelines and criteria in alignment with departmental policies and state and federal regulations • Monitor and organize clinical-focused Standard Operating Procedures (SOP) and collaborate with leadership to ensure compliance • Evaluate departmental performance and implement improvements based on industry best practices and data analysis Required qualifications: • Registered Nurse (RN) license required • Master's degree (MA/MS) preferred • 3-5 years of related experience in clinical policy development • Experience with MCG clinical guidelines is required • Technological proficiency and ability to collaborate across teams
Centene Corporation is a large diversified healthcare company that provides managed care and related services to government-sponsored and commercial healthcare programs, including Medicaid, Medicare, and specialty services.
