[Hiring] Registered Nurse Clinical Reviewer @Greenlife Healthcare Staffing

Role Description

Greenlife Healthcare Staffing is currently seeking a Registered Nurse Clinical Reviewer / AIMS to fill an opening with a Non-profit organization located in New York. This remote position is ideal for an experienced RN with a background in acute care utilization review who is detail-oriented, flexible, and capable of working independently.

Qualifications

• Education: Baccalaureate degree in Nursing or graduate of an approved Registered Professional Nurses training program.
• Licensure: Licensed as a Registered Professional Nurse in New York State.
• Experience:
  • A minimum of two (2) years of experience in an acute care facility, preferably in medicine/surgery or special care units; and/or one to three (3) years of experience in acute care utilization review.
• Technical Skills:
  • Knowledge and experience with electronic medical records (EMR), including utilization, quality, and clinical charting.
  • Experience with InterQual and Milliman (MCG) criteria.
  • Proficiency in completing electronic worksheets and data entry.
• Soft Skills:
  • Ability to oversee, problem-solve, and work collaboratively with peers, medical, analytical, and administrative support staff.
  • Excellent written and verbal communication skills.
  • Ability to work independently with little supervision.
  • Ability and desire to be flexible, innovative, and creative.
  • Strong attention to detail and ability to meet deadlines in a time-sensitive environment.

Requirements

• This individual will complete the full spectrum of activities related to Utilization or Quality reviews as assigned.
• Conduct utilization reviews up to and including the appeal level, including chart screen, complete electronic worksheets, enter required information, and make level one denial decisions when necessary.
• Conduct quality and clinical study data collection reviews, including chart review and complete detailed electronic data worksheets.
• Act as a resource for the administrative staff in training, problem-solving, and clarifying procedures, providing technical assistance and conducting/participating in staff huddles.
• Participate in collaborative training specific to clinical study objectives.
• Other activities as may be deemed necessary.

Benefits

• Competitive Compensation: Earn a competitive rate of $50 per hour.
• Comprehensive Benefits:
  • 1 Week of Paid Vacation based on accruals after 3 months of employment (2 weeks of Paid Vacation with accrual starting your second year of employment).
  • 6 Major Paid Holidays per year.
  • 5 Sick Days (40 Hours) subject to the provisions of the NYS Paid Sick Leave Act.
  • License Reimbursement after 1 year of employment.
  • Health insurance is subject to plan eligibility requirements.
  • 401k 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 position, Monday to Friday, with remote work flexibility.
• Professional Growth: Gain valuable experience in utilization review, quality improvement, and clinical study data collection within a supportive non-profit environment.
• Impactful Work: Contribute to a mission-driven organization dedicated to improving patient outcomes through thorough clinical reviews and evidence-based determinations.