RN Clinical Reviewer / IDR - Remote to Office-Based Setting

RN Clinical Reviewer / IDR - Remote to Office-Based Setting - Jericho, NY (#25309) • Location: Hybrid (Remote to Office-Based) - Jericho, NY • Employment Type: Full-time • Hourly Rate: For remote, it's $50/hr, and as soon as the candidate transitions into an office-based position, the rate will be increased to $60/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 seeking an experienced Registered Nurse Clinical Reviewer (IDR) to join a Non-profit organization located in New York. This hybrid role combines remote work with office-based responsibilities, focusing on conducting comprehensive medical-legal reviews and appeals for a respected non-profit organization. Why Join Us? • Work Schedule: Full-time, Hybrid (Remote to Office-Based) • Professional Growth: Gain valuable experience in medical-legal review and dispute resolution • Impactful Work: Contribute to fair resolution processes in healthcare disputes 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 Requirements 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 Benefits • Competitive Compensation: For remote, it's $50/hr, and as soon as the candidate transitions into an office-based position, the rate will be increased to $60/hr. • Comprehensive Benefits: • * Paid Vacation (after 6 months 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. Remote About the Company: Greenlife Healthcare Staffing Apply tot his job Apply To this Job