RN Clinical Reviewer

Greenlife Healthcare Staffing • Jericho, NY

11d • $50 - $60 • Hybrid

About The Position

Greenlife Healthcare Staffing is seeking an experienced Registered Nurse Clinical Reviewer (IDR) to join a Non-profit organization located in New York. This hybrid role combines remote work with office-based responsibilities, focusing on conducting comprehensive medical-legal reviews and appeals for a respected non-profit organization.

Requirements

• Baccalaureate degree in Nursing or a graduate of an approved RN program.
• Current New York State RN license
• Must have at least 3 years of experience in a Med-Legal review setting.
• Must have 1-3 years of experience in acute care utilization review/ appeals background.
• Experience with electronic medical records; strong research capabilities
• Excellent written/verbal communication; ability to work independently; flexible and innovative; meets deadlines in sensitive environments; strong collaborative and problem-solving skills

Responsibilities

• Conduct reviews up to and including the appeal level. This includes chart screen, 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

• Paid Vacation (after 6 months of employment)
• 6 Major Paid Holidays per year (after 6 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
• 93% retention of employees 2 years+, Google reviews, great company culture, etc.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 11-50 employees