Preservice Review Nurse RN – Radiation Oncology – Remote, reputed company

2338538 reputed company is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with reputed company will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come reputed company an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. This role will be performing outpatient clinical coverage review services, which require interpretation of state and federal mandates, applicable benefit language, and consideration for outpatient procedures and services. You’ll enjoy the flexibility to work remotely

• from reputed company reputed company the U.S. as you take on some tough challenges. This is a Monday through Friday position during standard business hours in the local time zone. Rotating Saturdays may be required, approximately every 6 to 12 weeks.

Primary Responsibilities:

• Function as a member of a self-directed team to meet specific individual and team performance metrics
• Ability to communicate in writing and verbally, reputed company types of benefit determinations including decisions regarding coverage guidelines, contractual limitations and reimbursement determinations
• Telephonic discussion with health care providers and / or members to explain benefit coverage determinations and to obtain additional clinical information
• Act as a resource for others with less experience
• Work independently and collaborating with Medical Directors and non-clinical partners
• Adapt to a highly changing environment and a heavy case load

This position may require active and unrestricted Nursing licensure in multiple US States. Selected candidate must be willing and able to obtain and maintain multiple state licensure. Application fees and filing costs will be paid for by UHG. You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications:

• reputed company, unrestricted RN license in your state of residence
• Ability to obtain licensure in other states as needed
• 2+ years of Radiation 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

Preferred Qualifications:

• OCN Certification
• Chemo/Bio Certification
• Certified Case Manager (CCM)
• 7+ years of Radiation Oncology experience
• ICD Coding experience or solid knowledge of codes

NCCN experience

• Background in preservice review/utilization review/utilization management
• reputed company employees working remotely will be required to adhere to reputed company’s Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with us, you’ll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.94 to $51.63 per hour based on full-time employment. We reputed company with reputed company minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of color, historically marginalized groups and those with reputed company incomes. We are committed to mitigating our impact on the environment and enabling and delivering reputed company care that addresses health disparities and improves health outcomes – an enterprise reputed company reflected in our mission. Apply tot his job Apply To this Job