Remote Oncology RN — Telephonic Preservice Review

UnitedHealth Group; Downers Grove (IL); Remote; USD 60,000 - 108,000; Full time

Job summary

UnitedHealth Group is seeking a Telephonic Oncology Preservice Review Nurse to perform pre-service clinical coverage reviews and determine medical appropriateness for outpatient services. This fully remote role operates Tue–Sat 8–5 in your time zone, with no evenings or on-call, and requires an active RN license in multiple states and the ability to obtain licensure elsewhere.

The position emphasizes compliance with federal/state requirements and coding review, collaborating with care

Qualifications

• Active RN license in your state of residence
• Ability to obtain licensure in other states as needed
• 3+ years of radiation oncology experience as a Nurse
• Oncology experience required/preferred
• Computer proficiency and data entry skills in a Windows environment
• Access to high-speed internet from home and a dedicated home office
• Willing to work Tuesday through Saturday 8–5 in your time zone

Responsibilities

• Determine appropriate team assignment for case reviews (e.g., Medicare, Medicaid, Commercial)
• Validate need for additional research on service requests
• Conduct non-clinical research using benefit documents and guidelines
• Prioritize cases based on urgency and timelines
• Ensure adherence to federal/state requirements and turnaround times
• Review clinical records andCodes for relevance and accuracy
• Identify missing information and request additional documentation as needed
• Apply medical terminology to interpret records
• Make clinical determinations per protocol
• Review care coordinator assessments and notes
• Utilize medical resources for research (e.g., MCG)

Skills

RN license

Oncology experience

Data entry

Internet at home

Windows proficiency

Tools

ICD Coding knowledge

EHR systems

Job description

UnitedHealth Group is seeking a Telephonic Oncology Preservice Review Nurse to perform pre-service clinical coverage reviews and determine medical appropriateness for outpatient services. This fully remote role operates Tue–Sat 8–5 in your time zone, with no evenings or on-call, and requires an active RN license in multiple states and the ability to obtain licensure elsewhere.

The position emphasizes compliance with federal/state requirements and coding review, collaborating with care