RN Clinical Reviewer
About The Position
Greenlife Healthcare Staffing is a leading nationwide recruitment agency dedicated to connecting healthcare professionals with top-tier opportunities. We partner with hospitals, clinics, nursing homes, multi-specialty groups, and private practices to match talented individuals with roles that align with their skills and career goals. We are seeking a skilled Registered Nurse Clinical Reviewer to join a team at a respected non-profit organization in Jericho, NY. This role combines clinical expertise with analytical review, focusing on utilization reviews, quality data collection, and appeal-level determinations to support healthcare quality improvement initiatives.
Requirements
- Baccalaureate degree in Nursing or graduate of approved Registered Professional Nurses training program
- Active New York State RN license
- Must have a minimum of 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 and experience with electronic medical records, including utilization, quality, and clinical charting.
- Ability to oversee, problem solve and work collaboratively with peers, medical, analytical, and administrative support staff.
- Excellent written and verbal skills.
- Ability to work independently with little supervision.
- Ability and desire to be flexible, innovative, and creative.
Responsibilities
- Conduct utilization reviews up to and including the appeal level. This includes chart screens, complete electronic worksheets, enter required information and make level one denial decisions when necessary.
- Conduct quality and clinical study data collection reviews. This includes chart review, complete detailed electronic data worksheets.
- Act as a resource for the administrative staff in training, problem solving, and clarifying procedures. Will provide technical assistance and conduct/participate in staff huddles.
- Participate in collaborative training specific to clinical study objectives.
- Other activities as may be deemed necessary.
Benefits
- 5 Sick Days (40 Hours) subject to the provisions of NYS Paid Sick Leave Act
- Benefits from Paychex, such as Payactiv
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
