Registered Nurse Clinical Reviewer / IDR

Greenlife Healthcare StaffingJericho, NY
$60Onsite

About The Position

Greenlife Healthcare Staffing is seeking a Registered Nurse Clinical Reviewer / IDR for a Non-profit organization in Jericho, New York. This role is for an experienced RN with a utilization review or appeals background who can work independently and meet deadlines. The position offers professional growth in independent dispute resolution (IDR), medical-legal review, and appeals within a supportive non-profit setting. The work is impactful, contributing to a mission-driven organization focused on improving patient outcomes through fair, evidence-based clinical determinations.

Requirements

  • Baccalaureate degree in Nursing or graduate of an approved Registered Professional Nurses training program.
  • Licensed as a Registered Professional Nurse in New York State.
  • 1–3 years of experience in utilization review and/or appeals background required.
  • At least 3 years of experience in a Med-Legal review setting.
  • Knowledge and experience with electronic medical records (EMR).
  • Ability to oversee, problem-solve, and work collaboratively with peers, medical, analytical, and administrative support staff.
  • Excellent written and verbal communication skills.
  • Ability to work independently with little supervision.
  • Ability and desire to be flexible, innovative, and creative.
  • Ability to meet deadlines in a time-sensitive environment.

Responsibilities

  • Conduct reviews up to and including the appeal level, including chart screens, compiling regulatory guidance, researching insurer requirements, completing electronic worksheets, and preparing final determinations.
  • Act as a resource for administrative and clinical staff in training, problem-solving, and clarifying determinations.
  • Provide technical assistance and conduct/participate in staff huddles.
  • Participate in collaborative training.
  • Perform other activities as may be deemed necessary.

Benefits

  • Competitive Compensation: $60 per hour based on experience.
  • 1 Week of Paid Vacation based on accruals after 3 months of employment (2 weeks of Paid Vacation with accrual starting your second year of employment).
  • 6 Major Paid Holidays per year (after 3 months of employment).
  • 5 Sick Days (40 Hours) subject to the provisions of NYS Paid Sick Leave Act.
  • License Reimbursement after 1 year of employment.
  • Health insurance is subject to plan eligibility requirements.
  • 401(k) Matching eligibility after 1 year of employment.
  • Benefits from Paychex, such as Payactiv.
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