Registered Nurse Clinical Reviewer / IDR
Greenlife Healthcare Staffing
Jericho, NY
Registered Nurse Clinical Reviewer / IDR - Remote to Office-Based Setting - Jericho, NY (#25310)
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?
- 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.
- 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
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
- Soft Skills: Excellent written/verbal communication; ability to work independently; flexible and innovative; meets deadlines in sensitive environments; strong collaborative and problem-solving skills
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