Oncology Preservice Review Nurse RN

[ad_1] Oncology Preservice Review Nurse RN - Remote – Amazon Store Skip to content September 6, 2025 Other Jobs To Apply Registered Nurse-GI/Endoscopy Lab Registered Nurse (RN) - Endoscopy Registered Nurse - Endoscopy Nurse LPN/RN - Licking Telehealth Specialty Medication Nurse (RN) – Hybrid Full Time Dispensing Nurse Certified Medication Technician Adventure Awaits: Breathe Easy in Rapid City! Breathe Easy in Cleveland: Your Next Therapy Adventure! 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Washington Travel Nurse RN - CVOR in Margate, FL Travel RN – Med Surg Travel Nurse Job in Pensacola, FL, Days, $-778 Wk CRNA Registered Nurse - Oncology Clinic @ UCSF Health Medical Center at Mission Bay Registered Nurse - Operating Room @ UCSF Health Medical Center at Parnassus Per Diem BCH Nursing Supervisor/Central Patient Placement RN Utilization Review Nurse (Remote) Clinical Review Nurse - Prior Authorization Exchange Plan Utilization Management Review Nurse Clinical Nurse (RN) - Interventional Radiology (1.0 FTE, 10-Hour Rotating Shifts, On-Call Required) Clinical Nurse (RN) - Cardiovascular Operating Room (0.9 FTE, 12-Hour Rotating Shifts, Call Required) Clinical Nurse (RN), Theragnostics Clinic - 1.0 FTE, Days (10HR) About the positionResponsibilities Determine that the case is assigned to the appropriate team for review (e.g., Medicare, Medicaid, Commercial) Validate that cases/requests for services require additional research Identify and utilize appropriate resources to conduct non-clinical research (e.g., benefit documents, evidence of coverage, state/federal mandates, online resources) Prioritize cases based on appropriate criteria (e.g., date of service, urgent, expedited) Ensure compliance with applicable federal/state requirements and mandates (e.g., turnaround times, medical necessity) Review/interpret clinical/medical records submitted from provider (e.g., office records, test results, prior operative reports) Identify missing information from clinical/medical documentation, and request additional medical or clinical documentation as needed (e.g., LOI process, phone/fax) Review and validate diagnostic/procedure/service codes to ensure their relevance and accuracy, as applicable (e.g., PNL list, EPAL list, state grid, LCDs, NCDs) Identify and validate usage of non-standard codes, as necessary (e.g., generic codes) Apply understanding of medical terminology and disease processes to interpret medical/clinical records Make determinations per relevant protocols, as appropriate (e.g., approval, denial process, conduct further clinical or non-clinical research) Review care coordinator assessments and clinical notes, as appropriate Identify relevant information needed to make medical or clinical determinations Identify and utilize medically-accepted resources and systems to conduct clinical research (e.g., clinical notes, MCG, medical) Requirements Current, unrestricted RN license in your state of residence Multiple state licensure (in addition to Compact License if applicable) or ability to obtain multiple state nursing licenses 3+ years of Oncology experience as a Nurse Computer proficiency, to include solid data entry skills and the ability to navigate a Windows environment Access to high speed internet from home (Broadband cable, Fiber or DSL) Dedicated workspace for home office set up Ability to work schedule listed Nice-to-haves OCN Certification Chemo/Bio Certification Certified Case Manager (CCM) Chemo infusion experience ICD Coding experience or solid knowledge of codes NCCN experience Background in preservice review/utilization review/utilization management Reside in Mountain or Pacific time zones Benefits Comprehensive benefits package Incentive and recognition programs Equity stock purchase 401k contribution Choosing a selection results in a full page refresh. 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