Registered Nurse Clinical Reviewer

• Location: Remote (New York).
• Employment Type: Full-time.
• Hourly Rate: $50/hr.

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.

Greenlife Healthcare Staffing is currently seeking a Registered Nurse Clinical Reviewer to fill an opening with a Non-profit organization located in New York. This remote position is ideal for an RN with 1-3 years of experience in utilization review, appeals, and prior authorization who is comfortable working independently in a technology-driven environment.

• Competitive Compensation: Earn a competitive rate of $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 the 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 position, Monday to Friday, with remote work flexibility.
• Professional Growth: Gain valuable experience in utilization review, appeals, and quality improvement within a supportive non-profit environment.
• Impactful Work: Contribute to a mission-driven organization dedicated to improving patient outcomes through thorough clinical reviews and evidence-based determinations.

• Education: Baccalaureate degree in Nursing or graduate of an approved Registered Professional Nurses training program.
• Licensure: Must have an active New York or Compact State license.
• Experience: Must have 1-3 years of experience in a utilization review/appeals background and prior authorization.
• Technical
  
  Skills:
  
  
  • Must be comfortable working on a computer.
  • Familiar with Outlook, spreadsheets (Excel), and Word.
  • Experience with electronic medical records and electronic worksheets.
• Soft Skills:
  • Excellent written and verbal communication skills.
  • Ability to work independently with little supervision.
  • Strong problem-solving skills and attention to detail.
  • Ability to work collaboratively with peers, medical, analytical, and administrative support staff.
  • Ability and desire to be flexible, innovative, and creative.
  • Ability to meet deadlines in a time-sensitive environment.

• Conduct utilization reviews up to and including the appeal level. This includes chart screens, 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 chart reviews and completing detailed electronic data worksheets.
• Act as a resource for the administrative staff in training, problem-solving, and clarifying procedures. Provide technical assistance and conduct/participate in staff huddles.
• Participate in collaborative training specific to clinical study objectives.
• Perform other activities as may be deemed necessary.

Greenlife Healthcare Staffing
- Empowering Healthcare Professionals, Enriching Lives.