Oncology Case Manager

Job Summary

To enhance patient care, the full-time Oncology Prior Authorization Case Manager will conduct chart reviews for clinical utilization and authorization, coordinate with healthcare teams, and manage a designated patient caseload remotely.

Key responsibilities:

• Perform timely prospective and concurrent reviews for services requiring prior authorization
• Facilitate communication regarding authorization status and manage denials between payers and the healthcare team
• Monitor treatment plans to identify potential delays and recommend alternative treatment options

Required qualifications:

• Bachelor's degree in a relevant field or equivalent experience
• Minimum of 2 years of relevant experience, preferably in oncology
• Knowledge of payer reimbursement policies and clinical guidelines
• Experience in conducting clinical reviews in accordance with established criteria
• Ability to communicate effectively with patients, families, and healthcare personnel