Registered Nurse Clinical Reviewer / IDR

Greenlife Healthcare Staffing • Jericho, NY

7h • $60 - $60

About The Position

Greenlife Healthcare Staffing is currently seeking a Registered Nurse Clinical Reviewer / IDR to fill an opening with a Non-profit organization located in Jericho, New York. This role is ideal for an experienced RN with a utilization review or appeals background who thrives in a collaborative, independent, and deadline-driven environment.

Requirements

• Baccalaureate degree in Nursing or graduate of an approved Registered Professional Nurses training program.
• Must be licensed as a Registered Professional Nurse in New York State.
• 1–3 years of experience in utilization review and/or appeals background required.
• Must have at least 3 years of experience in 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. This includes chart screens, compiling regulatory guidance, researching insurer requirements, completing electronic worksheets, and preparing final determinations.
• Act as a resource for the administrative and clinical staff in training, problem-solving, and clarifying determinations. Will provide technical assistance and conduct/participate in staff huddles.
• Participate in collaborative training.
• Other activities as may be deemed necessary.

Benefits

• 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
• GLHS is a great company to work for: 93% retention of employees 2 years+, Google reviews, great company culture, etc.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level