Registered Nurse Clinical Reviewer / AIMS

Greenlife Healthcare Staffing • Jericho, NY

18h • Remote

About The Position

Greenlife Healthcare Staffing is seeking a Registered Nurse Clinical Reviewer / AIMS for a remote position with a nonprofit organization in New York. The role is suited to an experienced registered nurse with acute care utilization review experience who can work independently, stay flexible, and maintain close attention to detail. The reviewer completes utilization or quality reviews, supports Medical Review Analysts and Physician Consultants, and helps ensure an appropriate and accurate review process. The position is full-time, Monday through Friday, and pays $50 per hour.

Requirements

• Baccalaureate degree in Nursing or graduation from an approved Registered Professional Nurses training program.
• Licensed as a Registered Professional Nurse in New York State.
• At least two years of experience in an acute care facility, preferably in medicine/surgery or special care units, and/or one to three years of experience in acute care utilization review.
• Knowledge of and experience with electronic medical records, including utilization, quality, and clinical charting.
• Experience with InterQual and Milliman (MCG) criteria.
• Proficiency in completing electronic worksheets and data entry.
• Ability to oversee, problem-solve, and collaborate with peers and 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.
• Strong attention to detail and ability to meet deadlines in a time-sensitive environment.

Responsibilities

• Complete the full spectrum of assigned utilization or quality review activities.
• Conduct utilization reviews through the appeal level, including chart screening, completing electronic worksheets, entering required information, and making level-one denial decisions when necessary.
• Conduct quality and clinical study data-collection reviews, including chart review and completion of detailed electronic data worksheets.
• Support Medical Review Analysts and Physician Consultants to ensure an appropriate and accurate review process.
• Serve as a resource for administrative staff by providing training, problem-solving assistance, and procedural clarification.
• Provide technical assistance and conduct or participate in staff huddles.
• Participate in collaborative training related to clinical study objectives.
• Perform other activities as deemed necessary.

Benefits

• One week of paid vacation based on accruals after three months of employment; two weeks of paid vacation with accrual starting in the second year.
• Six major paid holidays per year.
• Five sick days (40 hours), subject to the provisions of the NYS Paid Sick Leave Act.
• License reimbursement after one year of employment.
• Health insurance, subject to plan eligibility requirements.
• 401(k) matching eligibility after one year of employment.
• Benefits from Paychex, such as Payactiv.

What This Job Offers

• Job Type: Full-time