RN Clinical Reviewer

Greenlife Healthcare Staffing • Jericho, NY

4d • $45 - $50

About The Position

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

• Competitive Compensation: Earn $45 - $50 per hour, based on experience
• Comprehensive Benefits: 5 Sick Days (40 Hours) subject to the provisions of NYS Paid Sick Leave Act
• 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