Location
Oklahoma City
Job Type
Full-time
Posted
July 04, 2026
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.
**NOTE: Candidates** **must be fully licensed with one of the approved license/certifications listed below upon the submission of the Centene application.**
**Required Work Schedule: 8:00 am - 5:00 pm (CST) and a Rotating On-Call schedule**
**Position Purpose:** Performs clinical reviews needed to resolve and process appeals by reviewing medical records and clinical data to determine medical necessity for services in accordance with policies, guidelines, and National Committee for Quality Assurance (NCQA) standards.
+ Prepares case reviews for Medical Directors by researching the appeal, reviewing applicable criteria, and analyzing the basis for the appeal
+ Ensures tim...
**NOTE: Candidates** **must be fully licensed with one of the approved license/certifications listed below upon the submission of the Centene application.**
**Required Work Schedule: 8:00 am - 5:00 pm (CST) and a Rotating On-Call schedule**
**Position Purpose:** Performs clinical reviews needed to resolve and process appeals by reviewing medical records and clinical data to determine medical necessity for services in accordance with policies, guidelines, and National Committee for Quality Assurance (NCQA) standards.
+ Prepares case reviews for Medical Directors by researching the appeal, reviewing applicable criteria, and analyzing the basis for the appeal
+ Ensures tim...
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