Registered Nurse Clinical Reviewer / IDR - Albany, NY (#25305)
Location: Albany, NY
Employment Type: Full-time
Hourly Rate: $60/hr
About Greenlife Healthcare Staffing:
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.
Position Overview:
Greenlife Healthcare Staffing is currently seeking a Registered Nurse Clinical Reviewer to fill an opening with a Non-profit organization located in Albany, NY. This is a 100% on-site position that involves conducting comprehensive medical-legal reviews, research, and appeals while ensuring regulatory compliance and producing accurate final determinations for a respected non-profit organization.
Why Join Us?
- Competitive Compensation: Earn $60 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 after 3 months of employment
- Work Schedule: Full-time position
- Professional Growth: Gain valuable experience in medical-legal review and dispute resolution processes
- Impactful Work: Contribute to fair and accurate resolution of healthcare disputes
Qualifications:
- Education: Baccalaureate degree in Nursing or a graduate of an approved RN program
- Licensure: Current New York State RN license
- Experience: 3+ years in Med-Legal review setting; 1-3 years in acute care utilization review/appeals
- Technical Skills: Experience with electronic medical records; strong research and documentation abilities
- Soft Skills: Excellent written/verbal communication; ability to work independently and collaboratively; flexible, innovative, and creative; the ability to oversee, problem solve, and work collaboratively with peers, medical, analytical, and administrative support staff; meets deadlines in time-sensitive environments
Key Responsibilities:
- Conduct reviews up to and including the appeal level. This includes chart screen, 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
How to Apply: If you are an experienced RN Clinical Reviewer with IDR expertise, we want to hear from you! Submit your Resume/CV to hr@glhstaffing.com or call our office at (800) 608-4025 to learn more about this opportunity.
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