Greenlife Healthcare Staffing
Registered Nurse Clinical Reviewer / IDR
Jericho, New York•Full-time
$60 hourly
$60 hourly
About the Job
Registered Nurse Clinical Reviewer / IDR – Jericho, NY
Location: Jericho, NY
Employment Type: Full-time
Rate: $60/hour (based on experience)
Employment Type: Full-time
Rate: $60/hour (based on experience)
Position Overview:
We are seeking a Registered Nurse Clinical Reviewer / IDR to join 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.
Why You'll Love Working Here:
- Competitive rate of $60/hour based on experience.
- 1 week of paid vacation based on accruals after 3 months of employment (2 weeks with accrual starting your second year).
- 6 major paid holidays per year (after 3 months of employment).
- 5 sick days (40 hours), subject to the provisions of the NYS Paid Sick Leave Act.
- License reimbursement after 1 year of employment.
- Health insurance, subject to plan eligibility requirements.
- 401(k) matching eligibility after 1 year of employment.
- Additional benefits such as Payactiv.
- Full-time position.
- Valuable experience in independent dispute resolution (IDR), medical-legal review, and appeals within a supportive non-profit setting.
- Mission-driven work improving patient outcomes through fair, evidence-based clinical determinations.
Qualifications:
- Baccalaureate degree in Nursing, or graduate of an approved Registered Professional Nurses training program.
- Licensed as a Registered Professional Nurse in New York State.
- 1–3 years of experience in utilization review and/or appeals required.
- At least 3 years of experience in a Med-Legal review setting.
- Knowledge and experience with electronic medical records (EMR).
- 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.
- Flexibility, innovation, and creativity.
- Ability to meet deadlines in a time-sensitive environment.
Key Responsibilities:
- Conduct reviews up to and including the appeal level, including chart screens, compiling regulatory guidance, researching insurer requirements, completing electronic worksheets, and preparing final determinations.
- Act as a resource for administrative and clinical staff in training, problem-solving, and clarifying determinations; provide technical assistance and conduct/participate in staff huddles.
- Participate in collaborative training.
- Other activities as needed.