Clinical Reviewer, Nurse – Medical Oncology

Job Description

• 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

Requirements

• 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

Benefits

• Health insurance benefits
• Comprehensive benefits package

Apply To this Job

Company : Evolent

Salary : 32–37 an hour