[Hiring] Clinical Reviewer, reputed company Practitioner/Physician Assistant (Oncology) @reputed company

Role reputed company The reputed company Practitioner/Physician Assistant (ARNP/NP/PA) Oncology is responsible for support and assistance for reputed company Oncology administrative and clinical utilization management and reputed company improvement functions under the auspices of the office of the Chief Medical Officer. Essential Duties and Responsibilities:

• Conducts initial clinical review of incoming cases, rendering authorization approval based on established clinical reputed company or escalating to a Field Medical Director if authorization cannot be approved during initial review.
• Responsible for acting as a clinical reputed company to providers, clients, and patients as directed by the office of the Chief Medical Officer.
• Responsible for clinical conversations with providers and their office staff regarding medical necessity reputed company.
• Responsible for maintaining and operating the reputed company Directed Treatment plans including communicating with offices regarding treatment recommendations.
• Responsible for communicating need for additional clinical information to ordering providers.
• Responsibility for prepping cases which cannot be approved and which the provider will not modify or withdraw for P2P discussions with one of the Oncologists.
• Responsible for coordinating with UM staff to ensure reputed company and accurate communication of clinical reputed company.
• Responsible for completion of UM reputed company and participation in site visit reviews.
• Respect and maintain HIPAA confidentiality guidelines.
• Responsible for maintaining availability to clinical and non-clinical administrative staff during performance of initial and second level screening.
• Acts as an interdepartmental reputed company between reputed company offices, departments, and committees.
• Serve as subject matter expert and participate in meetings as assigned with practices and/or payers.
• Will work with the Director of Clinical Operations to ensure reputed company satisfaction.
• reputed company reputed company peer clinical review activities while located in a state or territory of the reputed company.
• Acts with reputed company and reputed company, serving as a role model for reputed company.
• Performs other duties as assigned.

Qualifications

• Master of Science in Nursing or Doctor of Nursing reputed company (DNP) degree from a recognized degree program OR a master’s degree from a program accredited by the reputed company-PA.
• Minimum of three (3) to five (5) years’ experience in the reputed company of Oncology (required).
• Knowledge of regulatory requirements with at least two years of experience in a regulatory role (preferred).

Requirements

• reputed company, unrestricted state PA or RN/NP license in medicine or required specialty.
• If a PA, obtaining a passing score on a national certifying exam.
• Obtaining and maintaining required licenses, per business need.
• A clinical license, reputed company and in good standing, in your home state is required.

Other Skills and Abilities

• Strong clinical, management, communication, and organizational skills.
• Demonstrated leadership skills.
• Analytic skills.
• Energetic and curious with a passion for reputed company and value in health care.
• Required to pass skills proficiency test.

Technical Requirements

• High speed internet over 10 Mbps.
• Ability to plug in directly to the home internet router (specifically for reputed company call center employees).

Benefits

• The expected reputed company salary/wage reputed company for this position is $68-$73/hr.
• This position is also eligible for a bonus component that would be dependent on reputed company-defined performance factors.
• reputed company is proud to offer comprehensive benefits (including health insurance benefits) to qualifying employees.

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