This role centers on physician-level oncology case review for complex cancer care, including peer-to-peer discussions with treating oncologists when cases do not initially meet medical necessity criteria. The clinician also helps shape evidence-based care pathways, supports practice transformation, and contributes to value-based oncology initiatives. Work includes collaboration with clinical, operational, and analytic teams, along with documentation, quality review, and audit support.
Key Responsibilities
- Conduct physician reviews of oncology cases using evidence-based medical necessity guidelines.
- Participate in peer-to-peer discussions with requesting oncologists to explain determinations and support care alignment.
- Provide subject matter expertise and support to other clinical reviewers.
- Participate in engagement sessions with oncology practices to promote evidence-based pathways and best practices.
- Collaborate on the design, build, and execution of value-based oncology initiatives.
- Partner with operational and analytic teams to assess intervention impact and identify improvement opportunities.
- Participate in audit processes to validate advance payment model payouts against documentation, performance metrics, and contracts.
- Document clinical decisions and peer interactions accurately and in a timely manner.
Required
- MD, DO, or MBBS degree.
- Board certification in Medical Oncology or Pediatric Oncology.
- At least 5 years of post-residency experience.
- Current unrestricted medical license.
- Experience in practice transformation, value-based care, or clinical quality improvement.
- Ability to communicate effectively and influence physician behavior.
Preferred
- Active clinical practice within the past 2 years.
- Multiple state medical licenses or willingness to obtain them.
Benefits & Perks
- Work/life balance and flexible work arrangements.
- Autonomy to manage work responsibilities.
- Comprehensive health insurance benefits for qualifying employees.
- Potential sign-on bonus.
- Base pay range of $130-$145 per hour.
- Home internet requirement for remote work.