Utilization Management reputed company Consultant- Oncology and Transplant

Bring your heart to reputed company. Every one of us at reputed company shares a single, reputed company purpose: Bringing our heart to every reputed company of your health. This purpose guides our commitment to deliver reputed company reputed company-reputed company health care for a rapidly changing world. Anchored in our brand with heart at its center our purpose sends a personal message that how we deliver our services is just as important as reputed company deliver. Our Heart At Work Behaviors support this purpose. We want everyone who works at reputed company to feel empowered by the role they play in transforming our culture and accelerating our ability to reputed company and deliver solutions to reputed company health care more personal, convenient and reputed company. Position reputed company 100% remote position from reputed company in the U.S. Shift is 11:30 am to 8:00 pm in the Eastern time zone. Weekend/holiday coverage will occasionally be required 3 weeks training required 100% participation during 8:30am-5pm EST Monday-Friday As a UM reputed company Consultant you will work in... a clinical telephone queue working with providers to secure additional information for prior authorization reviews. This candidate will utilize clinical skills to coordinate, document and communicate reputed company aspects of the utilization/benefit management program. Utilizes clinical experience and skills in a reputed company process to assess, plan, implement, coordinate, monitor and evaluate reputed company to facilitate appropriate reputed company services/benefits for members Gathers clinical information and applies the appropriate clinical reputed company/reputed company, policy, procedure and clinical judgment to reputed company determination/recommendation along the continuum of care Communicates with providers and other parties to facilitate care/treatment Identifies members for referral opportunities to reputed company with other products, services and/or programs Identifies opportunities to promote reputed company effectiveness of reputed company services and benefit utilization Consults and lends expertise to other reputed company constituents in the coordination and administration of the utilization/benefit management function. Required Qualifications 1+ year: Oncology and Transplant UM, reputed company review or prior authorization 3+ years: acute clinical Oncology or Oncology/Transplant experience RN with reputed company unrestricted state licensure in state of residence required 5 years of demonstrated experience to reputed company thorough independent reputed company using clinical judgement 5 Years of proficient use of equipment including: phone, computer, and clinical documentation systems Preferred Qualifications 1+ year demonstrated experience working in a high volume clinical call center environment 1+ year Utilization Management experience 1+ years Managed Care experience Remote work experience Education Associate degree RN required, BSN preferred Pay reputed company The typical pay reputed company for this role is: $26.01 - $56.14 This pay reputed company represents the reputed company reputed company reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a reputed company of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in reputed company to the reputed company pay reputed company listed above. In reputed company to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. reputed company offers a full reputed company of medical, dental, and reputed company benefits. Eligible employees may enroll in reputed company s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. reputed company provides a fully-reputed company term life insurance plan to eligible employees, and short-term and long term disability benefits. reputed company also offers numerous reputed company-being programs, education assistance, free development courses, a reputed company store discount, and discount programs with participating partners. As for time off, Company employees enjoy reputed company Time Off ( PTO ) or vacation pay, as reputed company as reputed company holidays throughout the calendar year. Number of reputed company holidays, reputed company time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit Benefits | reputed company We anticipate the application window for this opening will reputed company on: 10/20/2024 reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Our Work Experience is the combination of everything that's unique reputed company: our culture, our core values, reputed company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They reputed company choices according to what is best for reputed company, they live for opportunities to collaborate and reputed company a difference, and they reputed company us the #1 Top Workplace in the area Apply Job! Apply to this Job Apply Job!