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Remote Nurse Leader: Clinical Review & Healthcare Integrity

Centene Corporation

Kansas City, MO
  • Remote job

Centene Corporation is hiring a Manager of Clinical Review for a remote leadership role in healthcare integrity. You will lead clinical investigators, oversee complex FWA cases, and collaborate with providers across markets to ensure proper utilization of services. The role requires a strong clinical background with coding, nursing experience, and team management skills. Pay range and remote options are provided; 100% remote across multiple markets. #J-18808-Ljbffr Centene Corporation

Vacancy posted 2 days ago
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