Clinical Reviewer, Nurse Practitioner/Physician Assistant (Oncology)(Evening Hours preferred)

What You'll Be Doing

• Conduct initial clinical review of incoming cases and render authorization approvals.
• Act as a clinical liaison to providers, clients, and patients.
• Conduct clinical conversations with providers regarding medical necessity decisions.
• Maintain and operate Guideline Directed Treatment plans.
• Communicate the need for additional clinical information to ordering providers.
• Prep cases for peer-to-peer discussions with Oncologists.
• Coordinate with UM staff to ensure timely communication of clinical decisions.
• Respect and maintain HIPAA confidentiality guidelines.

Qualifications

• Master's degree in Nursing (MSN), Doctor of Nursing Practice (DNP), or an ARC-PA accredited master's program.
• Minimum of 3 to 5 years of experience in oncology practice.
• Current, unrestricted state PA, RN, or NP license.
• Active clinical license in your home state in good standing.

Technical Requirements

• High-speed internet over 10 Mbps with the ability to plug in directly to the home internet router.