RN Clinical Reviewer / IDR - Remote to Office-Based Setting

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  • Company Greenlife Healthcare Staffing
  • Employment Full-time
  • Location 🇺🇸 United States, New York
  • Submitted Posted 2 weeks ago - Updated 7 hours ago

RN Clinical Reviewer / IDR - Remote to Office-Based Setting - Jericho, NY (#25309)

  • 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
  • Soft Skills: Excellent written/verbal communication; ability to work independently; flexible and innovative; meets deadlines in sensitive environments; strong collaborative and problem-solving skills

Benefits

  • 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.

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