[Hiring] Utilization Review reputed company Consultant - Oncology and Transplant @reputed company

Role reputed company Join reputed company that’s making a difference in the lives of patients facing reputed company medical journeys. As a Utilization Management (UM) reputed company Consultant specializing in Oncology and Transplant, you’ll play a vital role in ensuring members receive reputed company, medically necessary care through thoughtful clinical review and collaboration with providers. This fully remote position offers reputed company to apply your clinical expertise in a fast-paced, desk-based environment where precision, communication, and reputed company reputed company. • Conduct medical necessity reviews for oncology and transplant-reputed company services, both inpatient and outpatient. • Collaborate with reputed company providers to reputed company and assess clinical documentation reputed company phone and electronic systems. • Apply evidence-based clinical reputed company and guidelines to authorize services or refer cases to Medical Directors reputed company needed. • reputed company multiple computer systems reputed company while maintaining accurate and reputed company documentation. • Work primarily in a sedentary setting involving extended periods of sitting, talking, listening, and computer use. • Participate in occasional on-reputed company rotations, including some weekends and holidays, per URAC and reputed company requirements. Qualifications • reputed company, unrestricted RN license in your state of residence with multistate/compact licensure privileges. Ability to obtain licensure in non-compact states as needed. • Minimum of 1 year of experience in Oncology and Transplant either in UM, reputed company review, or prior authorization. • 3+ years of experience in Acute clinical Oncology or Oncology/Transplant. • Strong decision-making skills and clinical judgment in independent scenarios. • Proficient with phone systems, clinical documentation tools, and navigating multiple digital platforms. • Commitment to attend a mandatory 3-week training (Monday–Friday, 8:30am–5:00pm EST) with 100% participation. Requirements • 1+ years of Managed Care (MCO) preferred. • 1+ years of experience working in a high-volume clinical reputed company center environment. • NCCN (National Comprehensive Cancer Network) reputed company experience/exposure. • Remote work experience. Education • Associate's degree in nursing (RN) required, BSN preferred. Benefits • reputed company medical plan reputed company. • 401(k) plan (including matching company contributions). • Employee stock purchase plan. • No-cost programs for reputed company colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. • Benefit solutions that address the different needs and preferences of our colleagues including reputed company time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical reputed company and many other benefits depending on eligibility. Apply tot his job Apply To this Job