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: Performs concurrent reviews, including determining member's overall health, reviewing the type of care being delivered, evaluating medical necessity, and contributing to discharge planning according to care policies and guidelines. Assists evaluating inpatient services to validate the necessity and setting of care being delivered to the member. - Performs concurrent reviews of member for appropriate care and setting to determine overall health and appropriate level of care - Reviews quality and continuity of care by reviewing acuity level, resource consumption, length of stay, and discharge planning of member - Works with Medical Affairs and/or Medical Directors as needed to discuss member care being delivered - Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member medical records in health management systems according to utilization management policies and guidelines - Works with healthcare providers to approve medical determinations or provide recommendations based on requested services and concurrent review findings - Assists with providing education to providers on utilization processes to ensure high quality appropriate care to members - Provides feedback to leadership on opportunities to improve appropriate level of care and medically necessity based on clinical policies and guidelines - Reviews member’s transfer or discharge plans to ensure a timely discharge between levels of care and facilities - Collaborates with care management on referral of members as appropriate - 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 and ability to determine overall health of member including treatment needs and appropriate level of care preferred. Knowledge of Medicare and Medicaid regulations preferred. Knowledge of utilization management processes preferred. License/Certification: - LPN - Licensed Practical Nurse - State Licensure required - For Health Net of California: RN license required - RN - Registered Nurse - State Licensure and/or Compact State Licensure For State of Nevada required *Must be licensed in Nevada. Location: Position is remote. 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

Job Description You will play a critical role in reviewing content that will support clinicians at the point of care and providing as-needed feedback throughout the content and product development cycle. Job Responsibilities - Collaborate with our multidisciplinary team to create and curate content focused on emerging medical technologies - Create, rate, and rank queries based on their relevance, safety, and efficacy, helping healthcare professionals make informed decisions. - Review and assess the potential impact of various technologies on medical practice, patient care, and clinical outcomes. - Stay abreast of the latest advancements in the field of healthcare technology to ensure the content remains current and up-to-date. - Provide expert insights and perspectives on the integration of emerging technologies in clinical settings. Qualifications and Prerequisites - Terminal medical degree (MD or DO), specializing in one of the following: Family Medicine, Internal Medicine, Emergency Medicine, Pathology, Pediatrics, OB/GYN, Radiology, Dermatology, Orthopedics, Neurology / Psychiatry, Surgery - At least 2 years of post-residency clinical experience - Active and unencumbered US-based license in good standing - Direct point of care experience within the US - Demonstrated interest and engagement with emerging technologies - Be comfortable working autonomously in a fully remote environment, must have proficiency in Microsoft Office (Outlook, Teams, and Excel) Benefits of this Role - Flexibility: Set your own work hours to match your lifestyle. Application Process If you are among the qualified candidates, one of our recruiters will email you with further details. About CACTUS Established in 2002, Cactus Communications (cactusglobal.com) is a leading technology company that specializes in expert services and AI-driven products which improve how research gets funded, published, communicated, and discovered. Its flagship brand Editage offers a comprehensive suite of researcher solutions, including expert services and cutting-edge AI products like Mind the Graph, Paperpal, and R Discovery. With offices in Princeton, London, Singapore, Beijing, Shanghai, Seoul, Tokyo, and Mumbai and a global workforce of over 3,000 experts, CACTUS is a pioneer in workplace best practices and has been consistently recognized as a great place to work. Awards and Recognition - Employers of the Future, 2024 - Excellence in Employer Branding (Gold), 2024 - ISO 17100 certification for translation services, 2024 - Future of Workplace Disruptor, 2023 - Top 100 Companies for Remote Jobs (Ranked #14), 2023 - Three-star “Eruboshi” certification, 2023 - India’s Best Workplaces™ for Women (Top 100), 2022 - Quartz’s Best Companies for Remote Workers, 2022 - HR Asia’s Best Companies to Work for in Asia, 2021

Job Description We are seeking Registered Nurses (RN), PAs, or NPs to evaluate AI-generated responses in the nursing health education space. This remote contract position requires advanced clinical expertise and academic experience to assess educational content quality and safety. Job Responsibilities - Review and evaluate AI-generated responses on nursing education topics - Rate responses based on: - Overall helpfulness - Comprehension - Correctness - Completeness - Educational harmfulness - Complete assigned queries within specified deadlines (approximately 15 minutes per query) - Provide detailed, professional assessments to support educational content development Qualifications and Prerequisites - Current Registered Nurse (RN), NP, or PA license in good standing - Minimum 2+ years RN experience - We are specifically seeking ICU nurses, with at least 2+ years experience in ICU Benefits of this Role - Flexibility: Set your own work hours to match your lifestyle. Application Process If you are among the qualified candidates, one of our recruiters will email you with further details. About CACTUS Established in 2002, Cactus Communications (cactusglobal.com) is a leading technology company that specializes in expert services and AI-driven products which improve how research gets funded, published, communicated, and discovered. Its flagship brand Editage offers a comprehensive suite of researcher solutions, including expert services and cutting-edge AI products like Mind the Graph, Paperpal, and R Discovery. With offices in Princeton, London, Singapore, Beijing, Shanghai, Seoul, Tokyo, and Mumbai and a global workforce of over 3,000 experts, CACTUS is a pioneer in workplace best practices and has been consistently recognized as a great place to work. Awards and Recognition - Employers of the Future, 2024 - Excellence in Employer Branding (Gold), 2024 - ISO 17100 certification for translation services, 2024 - Future of Workplace Disruptor, 2023 - Top 100 Companies for Remote Jobs (Ranked #14), 2023 - Three-star “Eruboshi” certification, 2023 - India’s Best Workplaces™ for Women (Top 100), 2022 - Quartz’s Best Companies for Remote Workers, 2022 - HR Asia’s Best Companies to Work for in Asia, 2021

Role Description As a Triage Specialist at PaceMate®, you'll join a team of experienced professionals dedicated to improving outcomes for patients with cardiac implantable electronic devices (CIEDs). Working remotely, you'll use your expertise in cardiac electrophysiology and device management to analyze remote transmission data and diagnostics, interpret complex arrhythmias, and provide the accurate clinical documentation that providers rely on to guide patient care. This role requires deep technical knowledge—you'll assess device function across multiple manufacturers, recognize abnormalities and arrhythmias, and recommend strategies to address issues. This is an overnight role with regularly scheduled shifts Sunday through Thursday, typically lasting 8–10 hours between 5:00 pm and 6:00 am EST. What You’ll Do - Remotely monitor patients with CIEDs using PaceMate®'s proprietary software - Triage high priority alert transmissions by analyzing ECG/EGM data and device diagnostics, identifying abnormal device function and complex arrhythmias per customer preferred alert preferences - Downgrade alert flags for transmissions deemed to be false positive or low priority - Document findings on transmissions accurately and professionally, communicating with providers as needed according to PaceMate®'s best practice standards and SOPs - Serve as the primary point of contact for after-hours alert notification calls - Serve as a subject-matter expert and primary resource for team members, providing guidance and support for urgent and emergent reporting needs - Maintain advanced knowledge of PaceMate® products and services (i.e. expertise in manufacturer and PaceMate® LIVE alerts) - Work independently to manage your daily workflow while collaborating closely with teammates and clinical leadership to ensure efficient, accurate, and timely interpretations - Maintain strict confidentiality and adhere to all HIPAA and PHI protocols - Contribute to our patient-centered care philosophy—at PaceMate®, every teammate is a caregiver whose role is to meet the needs of the patient - Other duties as assigned Qualifications - Minimum two years of recent cardiac device management experience, OR successful completion of a formal cardiac rhythm management program - IBHRE Certification (CCDS, CEPS, CDRMS) required; CCT or CRAT a plus - Hands-on experience interrogating and interpreting device diagnostics for at least three of the four major manufacturers: Medtronic, Abbott, Boston Scientific, and Biotronik - Proficiency in ECG/EGM interpretation, including complex arrhythmia recognition - Moderate to advanced technical skills - Dedicated home workspace free from distractions, with reliable internet connectivity and the ability to work independently while engaging actively with your team throughout the day Requirements - While performing the duties of this job, the employee is consistently required to remain in a stationary position, constantly operate a computer or other office equipment, and frequently communicate with customers and employees. - Must be able to exchange accurate information, with the ability to effectively utilize voice over internet protocol; and repetitive motions using fingers and forearms in data entry. - You must reside within the geography of the territory. - You must only work from within the contiguous United States. - If working from, residing at a location other than your legal address that PaceMate® has on file, employee must inform IT and get approval to do so. - Whenever Confidential information is carried by a PaceMate® worker into a foreign country; the information is either stored in some inaccessible form, such as an encrypted external storage media, or always remains in the worker's possession. - PaceMate® workers shall not take Secret PaceMate® information into another country unless the permission has been obtained from Physical Security management. Benefits - Full-time employees receive a comprehensive benefits package including health, dental, and vision insurance - HSA and FSA options - Short- and long-term disability - AD&D coverage - 401(k) retirement savings - Paid time off - Additional voluntary benefits including legal insurance, critical illness, hospital indemnity, and accident coverage - Employee assistance program - Financial wellness resources - Discount programs On top of a Robust Benefit Package, we are targeting a compensation range of $41.34-51.52 per hour, depending on education, experience, and certifications. This evening shift will also be eligible for an additional $4.00 per hour for certain hours worked, our generous shift differential.