Provide clinical expertise in radiation oncology to perform prior authorization reviews and conduct peer-to-peer consultations. Strategically guide product development projects and execute quality improvement activities for the radiation oncology program.
OncoHealth
12 Remote Job Openings at OncoHealth
The Case Review Specialist manages clinical documentation and processes pre-authorization requests to ensure timely determinations. They collaborate with clinical and non-clinical staff to facilitate case discussions and maintain internal systems.
Case Review Specialist – Phone Intake & Documentation
OncoHealth
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Full Time
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2 hours ago
OncoHealth
Manage high-volume inbound calls to facilitate case intake and documentation for cancer treatment reviews. Act as a liaison between providers and internal clinical teams to ensure cases progress according to established timelines and quality standards.
Lead the design and continuous improvement of non-clinical operations processes within the utilization management business unit. Focus on optimizing case intake, workflow efficiency, and leveraging data-driven decision-making to improve client outcomes.
The Medical Director provides clinical oncology expertise primarily focused on performing prior authorization reviews for chemotherapy treatment requests. They also collaborate on strategic initiatives involving real-world oncology data and contribute to research projects and publications.
The Medical Oncology Nurse performs clinical reviews of oncology requests and collaborates with medical teams to enable therapy decisions. They are responsible for patient advocacy, creating clinical documentation, and managing projects to improve quality of care.
The Radiation Coder reviews radiation billing codes for accuracy and compliance while triaging cases prior to clinical evaluation. They collaborate with nursing and medical teams to document rationales for approvals and denials and maintain radiation protocols.
Develop and maintain the Enterprise Data Platform by designing scalable data solutions and data warehouse environments. Support existing reporting and analytics data products using CI/CD and test-driven development best practices.
Design and maintain analytics and reporting solutions, including dashboards and self-service tools, to support business decision-making. Collaborate cross-functionally to operationalize insights and ensure data quality and governance across all products.
Lead the enterprise-wide compliance program focusing on utilization management and telehealth operations. Design and operationalize a compliance framework to ensure adherence to federal and state laws, CMS requirements, and accreditation standards.
The role involves building and maintaining analytics products while resolving client tickets and change requests related to data operations. It also requires collaborating with external vendors and participating in client calls to gather implementation requirements.
The Product Owner manages the team backlog and delivery outcomes for utilization management products, translating strategy into epics and user stories. They collaborate with cross-functional teams to prioritize features and ensure quality through clear acceptance criteria.
