RN Clinical Reviewer
Jericho, New York•Full-time
$45 - $50 hourly
$45 - $50 hourly
About the Job
RN Clinical Reviewer - Jericho, NY (#25314)
Location: Jericho, NY
Employment Type: Full-time
Hourly Rate: $45/hr - $50/hr
Employment Type: Full-time
Hourly Rate: $45/hr - $50/hr
Position Overview:
We are seeking a skilled Registered Nurse Clinical Reviewer to join a team at a respected non-profit organization in Jericho, NY. This role combines clinical expertise with analytical review, focusing on utilization reviews, quality data collection, and appeal-level determinations to support healthcare quality improvement initiatives.
Why Join Us?
- Competitive Compensation: Earn $45 - $50 per hour, based on experience.
- Comprehensive Benefits:
- 5 Sick Days (40 Hours) subject to the provisions of NYS Paid Sick Leave Act.
- 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, Monday - Friday
- Professional Growth: Gain valuable experience in utilization review, quality improvement, and clinical data analysis.
- Impactful Work: Contribute to a mission-driven organization dedicated to improving patient outcomes through rigorous clinical review processes
Qualifications:
- Education: Baccalaureate degree in Nursing or graduate of approved Registered Professional Nurses training program.
- Licensure: Active New York State RN license.
- Experience:
- Must have a minimum of two years of experience in an acute care facility, preferably in medicine/surgery or special care units; and/or one to three years of experience in acute care utilization review.
- Knowledge and experience with electronic medical records, including utilization, quality, and clinical charting.
- Skills:
- Ability to oversee, problem solve and work collaboratively with peers, medical, analytical, and administrative support staff.
- Excellent written and verbal skills.
- Ability to work independently with little supervision.
- Ability and desire to be flexible, innovative, and creative.
Key Responsibilities:
- Conduct utilization reviews up to and including the appeal level. This includes chart screens, complete electronic worksheets, enter required information and make level one denial decisions when necessary.
- Conduct quality and clinical study data collection reviews. This includes 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.