Clinical Reviewer, Nurse (Medical Oncology)

Evolent Specialty Services, Inc(2 months ago)

RemoteFull TimeMedior$64,000 - $74,000Clinical Operations

About this role

Evolent is hiring a Clinical Review Nurse focused on oncology-related prior authorization and utilization review to support health plans and providers caring for complex patient populations. The role works within RN/LVN/LPN scope under medical director guidance and helps advocate for members by coordinating timely, appropriate care. This position is designed for experienced clinical nurses and includes a performance-based bonus opportunity in addition to hourly pay.

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Required Skills

Utilization Review
Prior Authorization
Oncology
Medical Necessity
Clinical Documentation
Case Escalation
Provider Collaboration
Data Entry
Managed Care
InterQual

+3 more

Qualifications

RN License
LPN/LVN License
High School Diploma

About Evolent Specialty Services, Inc

evolent.com

Evolent Health is a healthcare technology and services company focused on transforming the way healthcare is delivered and paid for. By leveraging their innovative platform, Evolent partners with health systems to improve patient outcomes, reduce costs, and streamline operations across diverse care settings. Their solutions include support for population health management, care delivery optimization, and value-based care models, all aimed at enhancing the provider and patient experience in the American healthcare system. Evolent is dedicated to simplifying healthcare complexities to create a more effective and efficient care environment.

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