Oncology Prior Authorization Case Manager, Non-rn - Remote

University of Miami

Miami, FL, United States
Fully remote
Chart reviews for utilization and authorization
Coordinate with healthcare team
Liaison between patient and insurers
The incumbent conducts initial, concurrent and retrospective chart reviews for clinical utilization and authorization

Job Summary

  • The incumbent conducts initial, concurrent and retrospective chart reviews for clinical utilization and authorization.
  • They are accountable for a designated patient caseload and provide intervention and coordination to decrease avoidable delays.
  • The University of Miami offers competitive salaries and a comprehensive benefits package including medical, dental, tuition remission and more.

Matching Summary

The incumbent conducts initial, concurrent and retrospective chart reviews for clinical utilization and authorization.

Skills & Requirements

Must-have

  • chart reviews for utilization and authorization
  • coordinate with healthcare team
  • liaison between patient and insurers
  • communication of progress and determination
  • adhere to timely prospective review
  • accurate review of coverage benefits

Nice-to-have

  • proactive communication with leadership
  • education regarding payer policies
  • compliance with medical advice

Key Requirements

  • Bachelor's degree or equivalent
  • Minimum of 2 years relevant experience
  • Oncology experience preferred

Work Rights

Not specified

Tailored Resume

Cover Letter