State Licensed Oncology Reviewer

Job Summary

State Licensed Oncology Reviewer, responsible for conducting clinical reviews and authorizations in a full-time capacity, while serving as a liaison between providers and patients.

Key Responsibilities

• Conduct initial clinical reviews and authorize cases based on established criteria
• Act as a clinical liaison to providers and communicate medical necessity decisions
• Coordinate with utilization management staff to ensure accurate clinical decision communication

Required Qualifications, Training, and Education

• Master of Science in Nursing or Doctor of Nursing Practice (DNP) or a master's degree from an accredited ARC-PA program
• Three to five years of experience in Oncology practice
• Current, unrestricted state PA or RN/NP license in medicine or required specialty
• Knowledge of regulatory requirements with at least two years of experience in a regulatory role (preferred)
• Active clinical license in good standing in the home state is required