Position Summary
Natera is seeking an experienced Oncology Registered Nurse (RN) to support the clinical review and validation of AI-driven workflows that power Signatera reimbursement and coverage operations. This role will serve as a clinical subject matter expert responsible for reviewing complex oncology cases, auditing AI-generated clinical classifications, interpreting payer policy requirements, and providing feedback that improves the performance of Natera's clinical AI systems. The ideal candidate combines strong oncology expertise with a curiosity for technology and process improvement. This position is highly collaborative and will work closely with Clinical Operations, Revenue Cycle Management, Product, Engineering, and Data Science teams to improve the accuracy, scalability, and effectiveness of AI-assisted clinical review processes.
Primary Responsibilities
Clinical Case Review & Escalations
- 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 patients with multiple cancer diagnoses, complex treatment histories, and ambiguous documentation.
- Document findings and recommendations within internal systems including Salesforce, LIMS, and other workflow tools.
- Ensure accuracy and consistency of clinical review outcomes.
AI Audit & Validation
- Perform ongoing audits of 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.
AI Development Support
- Partner with Product, Engineering, and Data Science teams to improve clinical AI capabilities.
- Help define clinical decision logic and requirements used in AI-driven workflows.
- Translate clinical review findings into actionable recommendations for automation improvements.
- Support testing and implementation of new AI-enabled solutions.
- Contribute to the long-term evolution of Natera's oncology clinical intelligence platforms.
Policy & Coverage Expertise
- Develop expertise in payer coverage policies relevant to our Signatera product and oncology testing.
- Evaluate clinical documentation against coverage requirements.
- Assist in identifying cases that may require additional clinical review or reimbursement support.
- Stay current on evolving oncology standards, treatment pathways, and reimbursement trends.
Qualifications
Required
- 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
- 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.
Highly Preferred
- Oncology Certified Nurse (OCN).
- Experience with payer policies, utilization management, prior authorization, or medical necessity review.
- Experience supporting AI, automation, clinical decision support systems, or technology-enabled healthcare workflows.
- Experience using Salesforce, Epic, LIMS, or other healthcare technology platforms.
- Familiarity with molecular diagnostics, precision medicine, or MRD testing.