RN Clinical Reviewer – IDR

Greenlife Healthcare Staffing

Registered Nurse Clinical Reviewer responsible for conducting comprehensive medical-legal reviews remotely for a non-profit organization. Collaborating with administrative and clinical teams to ensure compliance and accurate determination.

Posted 4/17/2026full-timeRemote • New York • 🇺🇸 United StatesMid-LevelSenior💰 $50 per hourWebsite

About the role

Key responsibilities & impact

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

Requirements

What you’ll need

Education: Baccalaureate degree in Nursing or a graduate of an approved RN program.
Licensure: Current New York State RN license
Experience:
Must have at least 3 years of experience in a Med-Legal review setting.
Must have 1-3 years of experience in acute care utilization review/ appeals background.
Technical Skills: Experience with electronic medical records; strong research capabilities
Soft Skills: Excellent written/verbal communication; ability to work independently; flexible and innovative; meets deadlines in sensitive environments; strong collaborative and problem-solving skills

Benefits

Comp & perks

Competitive Compensation: $50/hr.
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)
5 Sick Days (40 Hours) subject to the provisions of NYS Paid Sick Leave Act
License Reimbursement after 1 year of employment
Health insurance is subject to plan eligibility requirements
401(k) 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.

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

Med-Legal reviewacute care utilization reviewelectronic medical recordsresearch capabilities

Soft Skills

written communicationverbal communicationindependent workflexibilityinnovationdeadline managementcollaborationproblem-solving

Certifications

Baccalaureate degree in NursingNew York State RN license