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 : Supports the prior authorization request to ensure all authorization requests are addressed properly and in the contractual timeline.

Aids utilization management team to document authorization requests and obtain accurate and timely documentation for services related to the members healthcare eligibility and access.

Supports authorization requests for services in accordance with the insurance prior authorization listSupports and performs data entry to maintain and update authorization requests into utilization management systemAssists utilization management team with ongoing tracking and appropriate documentation on authorizations and referrals in accordance with policies and guidelinesContributes to the authorization review process by documenting necessary medical information such as history, diagnosis, and prognosis based on the referral to the clinical reviewer for determinationRemains up-to-date on healthcare, authorization processes, policies and proceduresPerforms other duties as assignedComplies with all policies and standardsEducation / Experience :

Requires a High School diploma or GED.Entry-level position typically requiring little or no previous experience.

Understanding of medical terminology and insurance preferred.Pay Range : $15.68 - $22.54 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.

Total compensation may also include additional forms of incentives.Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different.

Last updated : 2024-06-16