RN Clinical Reviewer / IDR - Remote

RN Clinical Reviewer / IDR - Remote (#25310C)

Location: Remote
Employment Type: Full-time
Hourly Rate: $50/hr

Position Overview:

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, focusing on conducting comprehensive medical-legal reviews and appeals for a respected non-profit organization.

Why Join Us?

• 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.
• Work Schedule: Full-time
• Professional Growth: Gain valuable experience in medical-legal review and dispute resolution.
• Impactful Work: Contribute to fair resolution processes in healthcare disputes.

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.

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.

We are committed to our core values: integrity, honesty, and transparencyFinding a new position as a physician or allied health professional or filling a critical vacancy in your practice, clinic, hospital, or skilled care facility can be stressful and time-consuming.At Greenlife our mission is to make this process easier for you and help you through all the steps necessary to find that perfect new position or the healthcare professional to round out your team.We understand that every situation is different and our approach reflects that: we value personalized interaction with job seekers and employers, our searches are customized not cookie-cutter and our results speak for themselves: Happy job seekers and employers who found the right professional match through our services.