Oncology Utilization Review Nurse – Clinical Review Preparation

🔥 2 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 25%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Dane Street

WebsiteLinkedInAll Job Openings

51 - 200 employees

🏥 Healthcare

💼 Consulting

⚖️ Legal

Healthcare • Consulting • Legal

Dane Street is a national leader in Independent Medical Exams and Reviews, providing objective, compliant, and timely Independent Medical Examinations, Peer Reviews, and other medical reports. With a large network of over 16,000 physicians, the company offers its services across 25,000 locations and 100 specialties, including Workers' Compensation, Auto, Liability, and Disability claims. Dane Street supports Insurance Carriers, Third Party Administrators, Managed Care Organizations, and Federal/State entities with expert medical analyses, helping them make accurate determinations. The company is recognized for its quality, fast turnaround times, and efficient processes, earning accolades like the NCQA Accreditation in Utilization Management and the Great Place to Work certification.

📋 Description

• Communicate with customers, reviewers, physicians, and management to ensure completed reports are delivered by customer-requested due dates • Ensure reviewer reports are timely, complete, clinically accurate, and meet customer requirements and company best practices • Provide regular report status updates to clients • Evaluate physician reports against client and jurisdictional standards • Ensure clinical rationale supports physician determinations • Clarify ambiguous report questions with clients • Distribute final reports according to client-specific requirements • Coordinate clarification and addendum requests • Participate in client phone calls or meetings when reports are questioned • Follow up with clients for missing referral information • Work directly with physicians and office staff to resolve client questions and obtain clarifications • Follow up with physicians to ensure on-time report delivery • Provide verbal or written feedback and clarification requests to physicians • Obtain physician approval and signature for final reports • Review reports for data accuracy, spelling, grammar, and punctuation • Ensure state reporting requirements and client-specific formats and handling instructions are met • Provide oversight to team members as needed • Improve processes to support turnaround time, peer-to-peer success rates, fewer returned reports, and higher client satisfaction • Approve cases for release to clients • Coordinate quality issue reports and new reviewer reports with the VP of Clinical Operations • Perform other duties and special projects as assigned

🎯 Requirements

• LPN or RN license required • Associate’s or Bachelor’s Degree preferred • Business experience in a healthcare and/or insurance setting preferred • Exceptional communication skills • Clear understanding of company business lines • Critical-thinking ability • Ability to manage time efficiently and meet specific deadlines • Computer literacy and typing skills • Ability to supply and support own internet services • Uninterrupted internet connection required for work-from-home position • Ability to perform required lifting, bending, traveling, prolonged sitting, and computer work

🏖️ Benefits

• Medical, dental, and vision coverage for employees and families • Voluntary life insurance for employees, spouses, and children • Hospital indemnity, critical illness, accident indemnity, and pet insurance plans • Basic life insurance at no cost • Short-term disability coverage at no cost • Long-term disability coverage at no cost • Paid time off • 401(k) plan with company match • Apple equipment for remote workspace • Media stipend for remote workspace • Remote work arrangement

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