State Licensed Oncology Nurse Reviewer

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