Nurse Practitioner - Utilization Review

Nurse Practitioner

Join the transformative team at City of Hope, where we're changing lives and making a real difference in the fight against cancer, diabetes, and other life-threatening illnesses. City of Hope’s growing national system includes its Los Angeles campus, a network of clinical care locations across Southern California, a new cancer center in Orange County, California, and treatment facilities in Atlanta, Chicago and Phoenix. our dedicated and compassionate employees are driven by a common mission : To deliver the cures of tomorrow to the people who need them today.

We have an exciting opportunity for a Nurse Practitioner to join our team in Duarte, CA. We are searching for candidates with Medical Oncology or Hematology experience, If you have a passion to care for oncology patients, we encourage you to apply for this role

As a successful candidate, you will :

• Conduct utilization review of patient cases to ensure quality of care and appropriateness of services provided
• Review medical records and other clinical information to ensure compliance with established standards and guidelines
• Provide complex clinical information to insurance carriers and healthcare providers in peer to peer review.
• Assist with obtaining revised requests for authorizations from physicians and help managing clinal override requests.
• Utilize the City of Hope nursing process in clinical practice.
• Develop and follow protocols / standardized procedures for practice for Nurse Practitioners in the department.
• Assist in developing methods and systems for provision of medical care and overall department operations.
• Maintain open lines of communication with the physician and multidisciplinary health team regarding patient information.
• Develop and participate in performance improvement activities to evaluate the program's effectiveness in meeting patient care and departmental needs.
• Enhance professional growth and development through participation in educational programs, reviewing current literature, attending in-service meetings, and workshops.

Your qualifications should include :

Required Certification / Licensure :