Registered Nurse Clinical Reviewer

Registered Nurse Clinical Reviewer / IDR - Lake Success, NY (#25154 B)

Minimum of 1-3 years of experience in utilization review/appeals background

Greenlife Healthcare Staffing is currently seeking a Registered Nurse Clinical Reviewer to fill an opening with a Non-profit organization located in Lake Success, New York

Schedule of the Registered Nurse Clinical Reviewer:

• This is a Full-time position (6 months contract)
• The contract may be extended beyond six months, contingent upon client demand and the employee's performance

Responsibilities of the Registered Nurse Clinical Reviewer:

• Conduct reviews up to and including the appeal level. This includes chart screens, 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

Requirements

• Must have a Baccalaureate degree in Nursing or graduate of an approved Registered Professional Nurses training program and licensed to practice in the State of New York.
• Experience in a medical-legal review setting is preferred but not required.
• Must be licensed as a Registered Professional Nurse in New York State.
• Must have knowledge and experience with electronic medical records.
• Must have the ability to oversee, problem solve and work collaboratively with peers, medical, analytical, and administrative support staff.
• Must have excellent written and verbal skills.
• Must have the ability to work independently with little supervision.
• Must have the ability and desire to be flexible, innovative, and creative.
• Must have the ability to meet deadlines in time-sensitive environment
• Must have 1-3 years of experience in utilization review/appeals background

Benefits

• The salary for this position is $55 / hr

Greenlife Healthcare Staffing is a nationwide recruitment agency, matches both new grads and advanced practitioners to hospitals, clinics, nursing homes, multi-specialty groups, and private practices.