Registered Nurse Clinical Reviewer / AIMS
Remote•United States•Full-time
$50+ hourly
$50+ hourly
About the Job
Registered Nurse Clinical Reviewer / AIMS - Remote (#25299A)
Location: Remote.
Employment Type: Full-time.
Hourly Rate: $50/hr.
Employment Type: Full-time.
Hourly Rate: $50/hr.
Position Overview:
We are seeking an experienced Registered Nurse Clinical Reviewer to join a Non-profit organization located in New York. This fully remote position involves conducting utilization reviews and quality study data collection, ensuring compliance and accuracy in healthcare documentation for a respected non-profit organization.
Why Join Us?
- Competitive Compensation: Earn $50 per hour.
- 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.
- 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.
- 401k 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, Remote. Sunday to Thursday schedule.
- Professional Growth: Gain valuable experience in utilization review and clinical data analysis.
- Impactful Work: Contribute to healthcare quality improvement and accurate data collection.
Qualifications:
- Education: Graduate of an accredited nursing program.
- Licensure: Active New York State RN license.
- Experience: Must have 1-3 years of experience in acute care utilization review/appeals background.
- Technical Skills: Must be comfortable working on a computer. Familiar with Outlook, spreadsheets, and Word.
- Soft Skills: Strong analytical abilities, attention to detail, and ability to work independently in a remote environment.
Key Responsibilities:
- Conduct utilization reviews up to and including the appeal level. This includes chart screen, completing electronic worksheets, entering the required information, and making level one denial decisions when necessary.
- Conduct quality and clinical study data collection reviews. This includes a chart review, complete detailed electronic data worksheets.
- Act as a resource for the administrative staff in training, problem-solving, and clarifying procedures. Will provide technical assistance and conduct/participate in staff huddles.
- Participate in collaborative training specific to clinical study objectives.
- Other activities as may be deemed necessary.