Registered Nurse Clinical Reviewer / IDR

Registered Nurse Clinical Reviewer / IDR ? Jericho, NY (#25154D)

• Location:?Jericho, NY
• Employment Type:?Full-time
• Hourly Rate:?$60/hr (based on experience)

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 currently seeking a Registered Nurse Clinical Reviewer / IDR to fill an opening with a Non-profit organization located in Jericho, New York. This role is ideal for an experienced RN with a utilization review or appeals background who thrives in a collaborative, independent, and deadline-driven environment.

• Work Schedule:?Full-time position.
• Professional Growth:?Gain valuable experience in independent dispute resolution (IDR), medical-legal review, and appeals within a supportive non-profit setting.
• Impactful Work:?Contribute to a mission-driven organization dedicated to improving patient outcomes through fair, evidence-based clinical determinations.

  </li></ul> Key Responsibilities:

  • Conduct reviews up to and including the appeal level. This includes chart screens, 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 graduate of an approved Registered Professional Nurses training program.
  • Licensure:?Must be licensed as a Registered Professional Nurse in New York State.
  • Experience:
  • 1?3 years of experience in utilization review and/or appeals background required.
  • Must have at least 3 years of experience in Med-Legal review setting.
  • Technical Skills:?Knowledge and experience with electronic medical records (EMR).
  • 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.
  • Ability to meet deadlines in a time-sensitive environment.
  Benefits
  • Competitive Compensation:?Earn a competitive rate of $60 per hour based on experience.
  • 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.