Clinical Review RN, Oncology AI Review

Job Description:

• Review oncology patient records to determine whether cases meet clinical and payer policy requirements
• Serve as an escalation point for complex cases that cannot be accurately classified by AI workflows
• Analyze challenging clinical scenarios, including multiple cancer diagnoses, complex treatment histories, and ambiguous documentation
• Document findings and recommendations in Salesforce, LIMS, and other workflow tools
• Ensure accuracy and consistency of clinical review outcomes
• Audit AI-generated clinical determinations and data classifications
• Evaluate AI performance against established clinical review standards
• Identify errors, trends, and opportunities to improve automation accuracy
• Participate in validation activities for new AI models, workflows, and clinical review processes
• Provide structured feedback to improve future AI performance
• Partner with Product, Engineering, and Data Science teams to improve clinical AI capabilities
• Help define clinical decision logic and requirements for AI-driven workflows
• Translate clinical review findings into actionable automation recommendations
• Support testing and implementation of AI-enabled solutions
• Contribute to Natera's oncology clinical intelligence platforms
• Develop expertise in payer coverage policies relevant to Signatera and oncology testing
• Evaluate clinical documentation against coverage requirements
• Identify cases requiring additional clinical review or reimbursement support
• Stay current on oncology standards, treatment pathways, and reimbursement trends

Requirements:

• Active RN license (state or compact)
• BSN preferred; ADN with significant oncology experience considered
• 5+ years of oncology nursing experience in inpatient, outpatient, infusion, navigation, utilization review, clinical review, case management, or related settings
• Strong understanding of cancer biology, oncology treatment pathways, disease staging, and patient treatment journeys
• Experience reviewing and interpreting medical records and clinical documentation
• Strong critical thinking and clinical decision-making skills
• Ability to work independently in a fast-paced, evolving environment
• Excellent written communication and documentation skills
• Comfortable working extensively within technology platforms and digital workflows
• Oncology Certified Nurse (OCN) highly preferred
• Experience with payer policies, utilization management, prior authorization, or medical necessity review highly preferred
• Experience supporting AI, automation, clinical decision support systems, or technology-enabled healthcare workflows highly preferred
• Experience using Salesforce, Epic, LIMS, or other healthcare technology platforms highly preferred
• Familiarity with molecular diagnostics, precision medicine, or MRD testing highly preferred

Benefits:

• Comprehensive medical, dental, vision, life and disability plans for eligible employees and their dependents
• Free testing for employees and their immediate families
• Fertility care benefits
• Pregnancy and baby bonding leave
• 401k benefits
• Commuter benefits
• Employee referral program
• Equal Opportunity Employer and inclusive workplace commitment