Role 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: - 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. Qualifications - Requires graduation from an accredited school of nursing or a Bachelor’s degree in Nursing (BSN). - 2–4 years of related nursing experience. - A minimum of 2 years of acute care experience is 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. Requirements - LPN - Licensed Practical Nurse - State Licensure required. - NYS RN Licensure Strongly Preferred. Benefits - Competitive pay. - Health insurance. - 401K and stock purchase plans. - Tuition reimbursement. - Paid time off plus holidays. - 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.

• Develops clinical roadmaps for specific application areas based on healthcare trends and market insights. • Provides expert input to support product strategy, marketing decisions, and clinical policy development. • Bridges market needs and internal teams by identifying unmet clinical demands and promoting best practices and success stories. • Participates in the development of comprehensive clinical roadmaps for specific application areas. • Participates in marketing and development strategy meetings, contributing expert insights on product policies and clinical trends. • Facilitates the sharing of successful or innovative projects. • Communicates unmet clinical needs of the local market to internal teams. • Presents clinical research findings and innovative project outcomes during customer presentations. • Evaluates emerging medical technologies and clinical applications. • Collaborates with R&D, marketing, sales, and service teams.

• Lead complex studies such as NDA submissions or multi-protocol programs, coordinating activities across locations. • Perform project management activities including resource planning, timelines, and milestone management. • Serve as DMC Support Statistician, developing Charters and attending DMC Meetings. • Lead development of Statistical Analysis Plans, perform senior reviews of plans developed by others. • Conduct statistical review of TFLs for complex studies prior to delivery. • Review study-specific specifications. • Provide mentoring and training to less experienced staff. • Present knowledge at seminars and external meetings. • Attend bid defense meetings for complex studies. • Represent the department during audits.

• Conduct clinical studies according to FDA/GCP and ICH regulations and guidelines. • Provide medical care to patients, always ensuring patient safety comes first. • Perform all defined study activities (i.e., informed consent, screening, and protocol procedures which include but are not limited to vital signs, pregnancy tests, height, weight, ECGs, blood draw, etc.). • Record all patient information and results from tests as per protocol on required forms. • Complete IP accountability logs and associated information when required. • Report suspected non-compliance to relevant site staff. • Ensure that IRB approval is obtained prior to study initiation and that IRB requirements are met throughout the study. • Promote the company and build a positive relationship with patients to ensure retention. • Attend site initiation meetings and all other relevant meetings to receive training on the protocol. • Call patients, handle patient bookings, and perform follow-up calls when required to confirm bookings or provide information or results. • Log and complete information on sponsor systems, ensuring accuracy (i.e., case report forms, EDC, etc.) and timely completion. • Gather source documents, update patient files and notes, always ensuring relevant and up-to-date information is recorded. • Adhere to company COP/SCOP. • Dispose of waste according to standards and assist in maintaining a neat appearance of the facility when required.