RN Clinical Reviewer – IDR

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🕒 May 13

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Greenlife Healthcare Staffing

11 - 50 employees

Greenlife Healthcare Staffing is a New York based healthcare recruitment agency specializing in permanent hires and locum tenens. We match physicians and advanced practitioners to hospitals, clinics, nursing homes, multi-specialty groups, and private practices.

📋 Description

• 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

🎯 Requirements

• 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: $50/hr. • 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 (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 • GLHS is a great company to work for: 93% retention of employees 2 years+, Google reviews, great company culture, etc.

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