Supervisor, Appeals - Remote

Overview

As a Supervisor in Appeals at Centene, you will lead a clinical team to ensure appropriate care for our members while working remotely within the CST time zone.

In Short

• Supervise the Prior Authorization and Clinical Review team.
• Ensure adherence to performance, compliance, and quality standards.
• Collaborate to resolve complex member care issues.
• Monitor team performance and provide feedback.
• Educate the team on key initiatives and resources.
• Assist with onboarding and training new team members.
• Develop and implement UM policies and guidelines.
• Lead change initiatives within the team.
• Work remotely while adhering to CST time zone.
• Comply with all relevant policies and standards.

Requirements

• Graduate of an Accredited School of Nursing or Bachelor's degree.
• 4+ years of related experience required.
• Knowledge of utilization management and appeals principles preferred.
• RN - Registered Nurse - Compact State Licensure required.
• Strong leadership and coaching skills.
• Ability to monitor and improve team performance.
• Excellent communication skills.
• Experience in healthcare services.
• Ability to work independently in a remote setting.
• Commitment to compliance and quality standards.

Benefits

• Competitive pay and comprehensive benefits package.
• Health insurance and 401K options.
• Tuition reimbursement and paid time off.
• Flexible work schedules including remote options.
• Commitment to diversity and equal opportunity.
• Support for career development and growth.
• Access to innovative health solutions and programs.
• Incentives based on skills and experience.
• Comprehensive support for candidate journey.
• Equal opportunity employer policies.