Responsibilities
- Evaluate inpatient and outpatient services related to oncology and transplant for medical necessity.
- Communicate with healthcare professionals by phone and through digital platforms to collect and review clinical records.
- Use evidence-based guidelines to approve care services or escalate complex cases to Medical Directors as appropriate.
- Operate multiple digital systems efficiently while ensuring documentation is precise and completed promptly.
- Perform duties primarily in a seated environment, involving prolonged use of computers, phones, and active listening.
- Participate in periodic on-call shifts, including select weekends and holidays, in alignment with URAC standards and client expectations.
Benefits
- Access to low-cost health insurance, a 401(k) plan with employer match, and an opportunity to purchase company stock.
- Free resources for all employees, including health assessments, programs to support tobacco cessation and weight management, and confidential counseling for personal or financial concerns.
- Comprehensive benefit offerings tailored to diverse employee needs, such as paid leave, flexible scheduling, parental leave, child care support, emergency assistance, educational funding, retiree health options, and additional eligible benefits.
Work Arrangement
Remote (Worldwide)
Schedule
Monday-Friday, 11:30am-8:00pm EST
Anticipated Weekly Hours
40
Time Type
Full time
Background Considerations
Applicants with arrest or conviction records will be evaluated in compliance with all applicable federal, state, and local laws.
Application Window
03/11/2026
