RN Clinical Reviewer
26 days ago
Jericho
Job Description RN Clinical Reviewer / IDR - Remote to Office-Based Setting - Jericho, NY (#25293) • Location: Hybrid (Remote to Office-Based) - Jericho, NY, • Employment Type: Full-time, • Hourly Rate: For remote, it's $50/hr, and as soon as the candidate transitions into an office-based position, the rate will be increased to $60/hr About Greenlife Healthcare Staffing: 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. Position Overview: 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. Why Join Us? • Work Schedule: Full-time, Hybrid (Remote to Office-Based), • Professional Growth: Gain valuable experience in medical-legal review and dispute resolution, • Impactful Work: Contribute to fair resolution processes in healthcare disputes Key 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 Greenlife Healthcare Staffing - Empowering Healthcare Professionals, Enriching Lives Requirements Qualifications: • Education: Baccalaureate degree in Nursing or a graduate of an approved RN program., • Licensure: Current New York State RN license, • Experience:, • 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., • Technical Skills: Experience with electronic medical records; strong research capabilities, • Competitive Compensation: For remote, it's $50/hr, and as soon as the candidate transitions into an office-based position, the rate will be increased to $60/hr., • Comprehensive 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, • GLHS is a great company to work for: 93% retention of employees 2 years+, Google reviews, great company culture, etc.