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Role Description

Greenlife Healthcare Staffing is seeking an experienced Registered Nurse Clinical Reviewer (IDR) to join a Non-profit organization located in New York. Responsibilities include conducting comprehensive medical-legal reviews and appeals.

• Conduct reviews up to and including the appeal level, including chart screening, 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.
• Provide technical assistance and conduct/participate in staff huddles.
• Participate in collaborative training.
• Other activities as may be deemed necessary.

Qualifications

• Baccalaureate degree in Nursing or a graduate of an approved RN program.
• Current New York State RN license.
• At least 3 years of experience in a Med-Legal review setting.
• 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.

Requirements

• Full-time employment.

Benefits

• Hourly Rate: $60/hr
• 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.

How to Apply

If you are ready to advance your career, we want to hear from you! Submit your Resume/CV to hr@glhstaffing.com or call our office at (800) 608-4025 to learn more about this opportunity.