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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.

+ **Schedule: Monday–Friday, 8:00 a.m.–5:00 p.m. PT**

+ **Weekend/Holiday Coverage: Some holidays and occasional weekends as needed**

+ **Remote Location Requirements: Nevada residents preferred**

+ **Time Zone Alignment: Team is based in Pacific Time**

+ **Utilization Review experience within a managed care organization**

+ **Coordinate with facilities, members, Health Plan leadership, and internal departments to support discharge planning**

+ **Helpful knowledge: Post-acute care, home health, and prior authorization review**

**Position Purpose:** Develops, assesses, and coordinates complex discharge plans for high-risk members based upon needs assessment. Assists with the facilitation of a smooth transition from the acute care setting to the next level of care and educates members and their families/caregivers on discharge plan to ensure appropriate high-quality transitional care.

+ Develops complex discharge plans based on level of care of members needs determined by needs assessment to ensure appropriate level of care

+ Interacts with providers, community agencies, and other utilization review staff to coordinate and ensure a safe, effective, and clinically appropriate transition plan for the member

+ Assists with managing member’s discharge plans to ensure a timely and smooth discharge between levels of care and facilities

+ Collects, documents, and maintains all discharge plans taken on member medical records in health management systems according to utilization management policies and guidelines

+ Assists with providing education to members and their families on discharge plan and utilization processes to ensure high quality appropriate care to members, as applicable

+ Provides feedback to leadership on opportunities to improve the discharge planning process for members to ensure high-quality transitional care

+ Coordinates and assists with completion of prior authorizations as they related to discharge planning, as applicable

+ Assists concurrent review team as needed

+ 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 of discharge planning competencies preferred.

Knowledge of Medicare and Medicaid regulations preferred.

Knowledge of utilization management processes preferred.

License/Certification: LPN - Licensed Practical Nurse - State Licensure 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