20 Best Registered Nurse jobs in Ballwin, MO (Hiring Now!)

Clinical Review Nurse - Prior Authorization
Centene —Clayton, MO
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time…
$25.97 - $46.68 an hour
1d
RN Case Manager
Hope Hospice Inc —St. Louis, MO
A valid driver’s license. A Registered Nurse license in good standing. Complete, maintain, and submit accurate and relevant clinical notes regarding the patient…
Estimated: $72.3K - $91.6K a year
Quick Apply
Registered Nurse - RN Interventional Radiology
SSM Health —St. Louis, MO
Uses the nursing process to develop and implement the plan of care, collect assessment data for each patient, determine appropriate nursing diagnoses, identify…
$30.96 an hour
Registered Nurse - RN Cath Lab
SSM Health —St. Louis, MO
Maintains current license and certifications. Demonstrates accountability for own professional practice. Not complain to or complain in front of my patients…
$29 an hour
Registered Nurse Case Manager (RN)
Unity Hospice —St. Louis, MO
Valid Registered Nurse (RN) license. Driver’s license, insurance and vehicle. Supportive and welcoming work environment. Job title: Nurse Case Manager (RN).
Estimated: $65K - $82.4K a year
Quick Apply
Registered Nurse (RN)
Victory Men's Health —St. Louis, MO
With business hours (M-TH 8:30am-5:00pm) and early Fridays off (8:30am-2:00pm), you'll have ample time to pursue your passions outside of work while making a…
$29 - $36 an hour
Quick Apply
Registered Nurse/LPN,/ Medical Assistant
Allergy Associates, Inc. —Saint Peters, MO
Triage phone calls and messages for physicians. Triage phone calls and messages for physicians. Maintain treatment rooms including stocking and cleaning.
$21 - $29 an hour
Quick Apply
9d
RN 7a-7p Full Time
Marymount Skilled Nursing & Rehabilitation —Eureka, MO
Current and valid Missouri RN / LPN license. Work within the scope of your license. Assist in the dining room during meal times.
Estimated: $57.8K - $73.2K a year
Quick Apply
9d
Registered Nurse (RN)
Viking Alternative Medicine, LLC —Chesterfield, MO
Valid Registered Nurse (RN) license in the state of Missouri. Nurse line calls to asssist patients with results or side effect questions.
From $30 an hour
Quick Apply
8d
Registered Nurse - RN Operating Room Regional Float Pool
SSM Health —St. Louis, MO
Uses the nursing process to develop and implement the plan of care, collect assessment data for each patient, determine appropriate nursing diagnoses, identify…
$30.96 an hour
Registered Nurse - RN Operating Room
SSM Health —St. Louis, MO
Uses the nursing process to develop and implement the plan of care, collect assessment data for each patient, determine appropriate nursing diagnoses, identify…
$30.96 an hour
Registered Nurse-Triage Call Center Adults
Peoples Family of Corporations —St. Louis, MO
Graduate of an accredited School of Nursing or Bachelor Degree in Nursing (BSN) with a valid Missouri Nursing License.
Estimated: $77K - $97.5K a year
Quick Apply
2h
Utilization Review Nurse - RN
BJC HealthCare —St. Louis, MO
Pension Plan*/403(b) Plan funded by BJC. Uses clinical and analytical skills to review and interpret diagnostic test results to determine appropriateness of…
$32.80 - $50.39 an hour
Registered Nurse - RN ICU
SSM Health —Fenton, MO
Uses the nursing process to develop and implement the plan of care, collect assessment data for each patient, determine appropriate nursing diagnoses, identify…
$30.96 an hour
Registered Nurse - RN Medical Surgical
SSM Health —Saint Charles, MO
Uses the nursing process to develop and implement the plan of care, collect assessment data for each patient, determine appropriate nursing diagnoses, identify…
$30.96 an hour
RN Supervisor - 7p-7a
The Woodlands of Arnold —Arnold, MO
Current and valid Missouri RN license. Work within the scope of your license. Assist in the dining room during meal times. Shift Differential for night shifts.
Estimated: $66.2K - $83.8K a year
Quick Apply
11d
Registered Nurse
Florissant Surgery Center —Florissant, MO
Proven experience as a registered nurse. Perform routine procedures (blood pressure measurements, starting ivs, administering eye drops etc.) and fill in…
Estimated: $63.3K - $80.2K a year
Quick Apply
12d
Registered Nurse (RN)
Bethesda Health —St. Louis, MO
Current RN license in the state you will be working. Assists in answering call lights and assists with resident care such as ADLs.
Estimated: $67.4K - $85.3K a year
5d
RN -Private Care Post Op Cosmetic
RN Services Private Duty Care —Ballwin, MO
Complies with all state and local regulations and accreditation standards, including current CPR certification. Minimum of two years nursing experience.
$40 - $50 an hour
Quick Apply
Registered Nurse - RN Step Down ICU
SSM Health —St. Louis, MO
Uses the nursing process to develop and implement the plan of care, collect assessment data for each patient, determine appropriate nursing diagnoses, identify…
$30.96 an hour

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Clinical Review Nurse - Prior Authorization

Centene - Clayton, MO

Apply Now

Job Details

Full-time $25.97 - $46.68 an hour 1 day ago

Benefits

Health insurance
401(k)
Tuition reimbursement
Paid time off

Qualifications

Nursing
Medicare
Bachelor's degree
Utilization management
Discharge planning
LPN
2 years

Full Job Description

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: Analyzes all prior authorization requests to determine medical necessity of service and appropriate level of care in accordance with national standards, contractual requirements, and a member's benefit coverage. Provides recommendations to the appropriate medical team to promote quality and cost effectiveness of medical care.

Performs medical necessity and clinical reviews of authorization requests to determine medical appropriateness of care in accordance with regulatory guidelines and criteria
Works with healthcare providers and authorization team to ensure timely review of services and/or requests to ensure members receive authorized care
Coordinates as appropriate with healthcare providers and interdepartmental teams, to assess medical necessity of care of member
Escalates prior authorization requests to Medical Directors as appropriate to determine appropriateness of care
Assists with service authorization requests for a member’s transfer or discharge plans to ensure a timely discharge between levels of care and facilities
Collects, documents, and maintains all member’s clinical information in health management systems to ensure compliance with regulatory guidelines
Assists with providing education to providers and/or interdepartmental teams on utilization processes to promote high quality and cost-effective medical care to members
Provides feedback on opportunities to improve the authorization review process for members
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.

Clinical knowledge and ability to analyze authorization requests and determine medical necessity of service preferred.
Knowledge of Medicare and Medicaid regulations preferred.
Knowledge of utilization management processes preferred.

License/Certification:

LPN - Licensed Practical Nurse - State Licensure required

Location: Position is 100% remote. Will work CST hours/weekend rotation/holidays

Pay Range: $25.97 - $46.68 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. 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.

Apply Now

Registered Nurse jobs in Ballwin, MO

Clinical Review Nurse - Prior Authorization

RN Case Manager

Registered Nurse - RN Interventional Radiology

Registered Nurse - RN Cath Lab

Registered Nurse Case Manager (RN)

Registered Nurse (RN)

Registered Nurse/LPN,/ Medical Assistant

RN 7a-7p Full Time

Registered Nurse (RN)

Registered Nurse - RN Operating Room Regional Float Pool

Registered Nurse - RN Operating Room

Registered Nurse-Triage Call Center Adults

Utilization Review Nurse - RN

Registered Nurse - RN ICU

Registered Nurse - RN Medical Surgical

RN Supervisor - 7p-7a

Registered Nurse

Registered Nurse (RN)

RN -Private Care Post Op Cosmetic

Registered Nurse - RN Step Down ICU

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