Registered Nurse Clinical Reviewer / AIMS

GreenLife Healthcare Staffing • Jericho, NY

2d • Remote

About The Position

Greenlife Healthcare Staffing is seeking a Registered Nurse Clinical Reviewer / AIMS for a full-time, remote role with a New York nonprofit organization. This position is suited to an experienced registered nurse with acute care utilization review experience who is detail-oriented, flexible, and able to work independently. The reviewer performs utilization and quality reviews, supports Medical Review Analysts and Physician Consultants, and helps ensure accurate, appropriate review processes. The role also includes clinical study data collection and collaboration with administrative and clinical staff.

The schedule is Monday through Friday, with remote work flexibility. The position pays $50 per hour. The posting describes opportunities to gain experience in utilization review, quality improvement, and clinical study data collection.

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.
• Flexibility, innovation, and creativity.
• Strong attention to detail and ability to meet deadlines in a time-sensitive environment.

Responsibilities

• Complete the full spectrum of utilization or quality review activities as assigned.
• Conduct clinical-level reviews using knowledge and expertise of the review program, supporting Medical Review Analysts and Physician Consultants.
• 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 reviews and completion of detailed electronic data worksheets.
• Support administrative staff with training, problem-solving, and clarification of procedures.
• Provide technical assistance and conduct or participate in staff huddles.
• Participate in collaborative training specific to clinical study objectives.
• Perform other activities as deemed necessary.

Benefits

• One week of paid vacation, accrued 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.
• Paychex benefits, such as Payactiv.

What This Job Offers

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