[Hiring] RN Clinical Reviewer / IDR @Greenlife Healthcare Staffing

Role Description

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

• Conduct reviews up to and including the appeal level, which includes:
  • Chart screening
  • Compiling regulatory guidance
  • Researching insurer requirements
  • Completing electronic worksheets
  • Preparing final determinations
• Act as a resource for the administrative and clinical staff in:
  • Training
  • Problem-solving
  • Clarifying determinations
• Provide technical assistance and conduct/participate in staff huddles.
• Participate in collaborative training.
• Other activities as may be deemed necessary.

Qualifications

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

Requirements

• Competitive Compensation: $50/hr.

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 (after 3 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.