About this role

Perform pre-certification utilization reviews of Oncology treatment requests (chemotherapy)
Determine medical necessity and appropriateness of services using clinical review criteria
Accurately document all review rationales and determinations
Appropriately identify and refer cases that do not meet established clinical criteria to the Medical Director
Collaborate with physicians and other providers to facilitate the provision of services throughout the health care continuum
Communicate appropriate information to other staff members as necessary/required

Registered Nurse or Licensed Practical/Vocational Nurse with a current, unrestricted license in your state of residence
High School Diploma or equivalent required
Minimum of three years of direct clinical patient care (acute, inpatient, or critical care setting); strongly prefer direct Oncology experience
Strong computer skills, including MS Office Suite
Strong interpersonal, oral, and written communication skills
Availability for 9 AM-6 PM Monday through Friday shift with weekend & holiday rotation

Clinical Reviewer, Nurse – Medical Oncology

Key skills