State Licensed Oncology Nurse Reviewer

Job Summary

A company is looking for a UM Nurse Reviewer - Oncology.

Key Responsibilities

• Apply oncology clinical expertise to ensure outputs align with payer requirements and evidence-based guidelines
• Monitor payer updates and oncology guideline changes to maintain a current knowledge base
• Collaborate with product and engineering teams to translate oncology-specific review requirements into actionable design

Required Qualifications

• Registered Nurse (RN) with an active license
• 3-5 years of experience in oncology utilization management or prior authorization
• Strong understanding of payer policies and oncology authorization workflows
• Working knowledge of ICD-10 and CPT coding
• Comfort with technology platforms and interest in AI or decision support systems