Clinical Review RN, Oncology AI Review

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $82.4k - $103k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🤖 Artificial Intelligence

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Natera

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2004

🧬 Biotechnology

⚕️ Healthcare Insurance

💊 Pharmaceuticals

Biotechnology • Healthcare Insurance • Pharmaceuticals

Natera is a global leader in cell-free DNA testing technology, specializing in non-invasive genetic testing and diagnostics. The company's innovative solutions focus on areas such as prenatal screening, cancer detection, and organ transplant monitoring. By using advanced bioinformatics and DNA analysis, Natera provides healthcare professionals and patients with critical information to make more informed medical decisions.

📋 Description

• Review oncology patient records to determine whether cases meet clinical and payer policy requirements. • Serve as an escalation point for complex cases that cannot be accurately classified by AI workflows. • Analyze challenging clinical scenarios, including patients with multiple cancer diagnoses, complex treatment histories, and ambiguous documentation. • Document findings and recommendations within internal systems including Salesforce, LIMS, and other workflow tools. • Ensure accuracy and consistency of clinical review outcomes. • Perform ongoing audits of AI-generated clinical determinations and data classifications. • Evaluate AI performance against established clinical review standards. • Identify errors, trends, and opportunities to improve automation accuracy. • Participate in validation activities for new AI models, workflows, and clinical review processes. • Provide structured feedback to improve future AI performance. • Partner with Product, Engineering, and Data Science teams to improve clinical AI capabilities. • Help define clinical decision logic and requirements used in AI-driven workflows. • Translate clinical review findings into actionable recommendations for automation improvements. • Support testing and implementation of new AI-enabled solutions. • Contribute to the long-term evolution of Natera's oncology clinical intelligence platforms. • Develop expertise in payer coverage policies relevant to our Signatera product and oncology testing. • Evaluate clinical documentation against coverage requirements. • Assist in identifying cases that may require additional clinical review or reimbursement support. • Stay current on evolving oncology standards, treatment pathways, and reimbursement trends.

🎯 Requirements

• Active RN license (state or compact). • BSN preferred; ADN with significant oncology experience considered. • 5+ years of oncology nursing experience in inpatient, outpatient, infusion, navigation, utilization review, clinical review, case management, or related settings. • Strong understanding of cancer biology, oncology treatment pathways, disease staging, and patient treatment journeys. • Experience reviewing and interpreting medical records and clinical documentation. • Strong critical thinking and clinical decision-making skills. • Ability to work independently in a fast-paced, evolving environment. • Excellent written communication and documentation skills. • Comfortable working extensively within technology platforms and digital workflows.

🏖️ Benefits

• Comprehensive medical, dental, vision, life and disability plans for eligible employees and their dependents. • Free testing for Natera employees and their immediate families. • Fertility care benefits. • Pregnancy and baby bonding leave. • 401k benefits. • Commuter benefits. • Generous employee referral program.