RN Clinical Reviewer

RN Clinical Reviewer - Jericho, NY (#25314)

Location: Jericho, NY
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.

We are committed to our core values: integrity, honesty, and transparencyFinding a new position as a physician or allied health professional or filling a critical vacancy in your practice, clinic, hospital, or skilled care facility can be stressful and time-consuming.At Greenlife our mission is to make this process easier for you and help you through all the steps necessary to find that perfect new position or the healthcare professional to round out your team.We understand that every situation is different and our approach reflects that: we value personalized interaction with job seekers and employers, our searches are customized not cookie-cutter and our results speak for themselves: Happy job seekers and employers who found the right professional match through our services.