Case Review Specialist

About OncoHealth

OncoHealth is a digital health organization focused on helping health plans, employers, providers, and patients handle the physical, emotional, and financial challenges of cancer through technology-enabled services. The company supports more than 14 million people across the United States and Puerto Rico with digital tools for treatment review and virtual care across all cancer types.

Role Overview

The Case Review Specialist is responsible for making sure provider documentation is received so case decisions can be made accurately and on time, while also coordinating with both clinical and non-clinical team members to keep case reviews moving.

What You Will Do

• Work flexible rotational shifts within office coverage hours of 8:00 a.m. to 8:00 p.m. EST, including Monday through Friday between 8:00 a.m. and 8:00 p.m. EST and Saturdays from 8:30 a.m. to 6:00 p.m. EST. Office hours may be adjusted or extended based on business needs.
• Manage cases by requesting and maintaining clinical records, then send determinations promptly through the internal system or by phone to providers, members, and/or payers.
• Receive pre-authorization requests and questions related to existing pre-authorizations through phone, email, fax, or portal, and make sure they are handled within required performance standards.
• Partner with clinical and non-clinical colleagues to support case conversations and resolution.
• Handle fax intake and labeling on weekends and holidays when needed.

About You

The ideal candidate can work independently in a remote setting, brings strong administrative or customer service experience, and is comfortable operating in a process-driven environment. Experience with pre-authorizations and health insurance client services is preferred, along with the ability to put systems in place that improve productivity and program effectiveness. Proficiency with the MS Office Suite is required.

Work Location

OncoHealth supports remote, hybrid, and in-office arrangements. Most of the team works remotely or in hybrid setups, with offices in Atlanta, Georgia and Guaynabo, Puerto Rico. The company accepts applicants from across the United States, though the work is primarily aligned with Eastern and Central time zones.

Culture and Mission

The company values quick action, critical thinking, and strong collaboration. Its leadership emphasizes respect, clinical excellence, innovation, and a patient-first mindset. OncoHealth also highlights a collaborative workplace with social activities and community events, along with a full benefits package available from day one and a company bonus.

Equal Opportunity

Employment decisions are based on qualifications, merit, and business need. The company provides equal employment opportunities without regard to race, color, religion, marital status, age, national origin, ancestry, physical or mental disability, medical condition, pregnancy, genetic information, gender, sexual orientation, gender identity or expression, veteran status, or any other status protected by applicable law.

Company Growth and Offering

OncoHealth says it is growing rapidly and remains in an investment phase, supported financially by Arsenal Capital Partners and McKesson Corporation. Its current solutions include OneUM, a single e-prior authorization portal for oncology drug requests and treatments; Oncology Insights Pro, an analytics platform for improving oncology programs; Pharmacy Consulting services for policy, utilization management, formulary, and training support; and Iris, a 24/7 oncology-specific telehealth platform offering personalized support for patients.