Join Dane Street as an Oncology Medical Reviewer, where you'll leverage your clinical expertise to evaluate medical necessity and ensure compliance with established guidelines, all while enjoying the flexibility of a telework schedule.
Key Responsibilities
Review medical records and address client questions using specific criteria
Ensure clear and concise rationale for medical necessity determinations
Utilize current guidelines and literature for decision-making
Make mandated telephone calls as required
Maintain proper credentialing and state licenses
Attend required orientation and training
Required Qualifications
Active Texas or New Mexico Medical License
Clinical expertise in Hematology/Medical Oncology
Preferred Qualifications
Experience in reviewing insurance appeals
Familiarity with evidence-based guidelines and standards of care