State Licensed Clinical Review Nurse

Job Summary

A company is looking for a Clinical Reviewer, Nurse (Medical Oncology).

Key Responsibilities

• Perform pre-certification utilization reviews of oncology treatment requests
• Determine medical necessity and appropriateness of services using clinical review criteria
• Collaborate with healthcare providers to facilitate service provision across the healthcare continuum

Required Qualifications

• Registered Nurse or Licensed Practical/Vocational Nurse with a current, unrestricted license
• High School Diploma or equivalent required
• Minimum of three years of direct clinical patient care, preferably in Oncology
• Minimum of one year of experience with medical management activities in a managed care environment
• Strong computer skills, including MS Office Suite