Registered Nurse Clinical Reviewer / IDR

Registered Nurse Clinical Reviewer / IDR - Remote to Office-Based, Albany, NY (#25305)

• Location: Albany, NY
• Employment Type: Full-time
• Hourly Rate: $50/hr

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 to fill an opening with a Non-profit organization located in Albany, NY. This remote to office-based position involves conducting comprehensive medical-legal reviews, research, and appeals while ensuring regulatory compliance and producing accurate final determinations for a respected non-profit organization.

Why Join Us?

• Work Schedule: Full-time, Remote to Office-Based position
• Professional Growth: Gain valuable experience in medical-legal review and dispute resolution processes
• Impactful Work: Contribute to fair and accurate resolution of healthcare disputes

Qualifications:

• Education: Baccalaureate degree in Nursing or a graduate of an approved RN program
• Licensure: Current New York State RN license
• Experience: 3+ years in Med-Legal review setting; 1-3 years in acute care utilization review/appeals
• Technical Skills: Experience with electronic medical records; strong research and documentation abilities
• Soft Skills: Excellent written/verbal communication; ability to work independently and collaboratively; flexible, innovative, and creative; the ability to oversee, problem solve, and work collaboratively with peers, medical, analytical, and administrative support staff; meets deadlines in time-sensitive environments

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

Greenlife Healthcare Staffing - Empowering Healthcare Professionals, Enriching Lives

Benefits

• Competitive Compensation: Earn $50 per hour
• Comprehensive Benefits:
• 1 Week of Paid Vacation based on accruals after 6 months of employment (2 weeks of Paid Vacation with accrual starting your second year of employment)
• 6 Major Paid Holidays per year after 6 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.