State Licensed Clinical Review Nurse

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