Registered Nurse / Medicaid Clinical Reviewer – Remote (#25291)
Location: Remote | Postal Code: 10018
Employment Type: Full-Time
Hourly Rate: $45 – $50/hr (Based on Experience)
Greenlife Healthcare Staffing is seeking a Registered Nurse – Medicaid Clinical Reviewer to join a respected non-profit organization. This fully remote role allows you to make a meaningful impact while maintaining work-life balance.
✅ Why Join Us
✔️ Competitive Pay: Earn $45–$50/hr depending on experience.
✔️ Comprehensive Benefits:
Paid Vacation (based on accruals)
6 Major Paid Holidays per year
5 Sick Days (40 Hours) under NYS Paid Sick Leave Act
License Reimbursement after 1 year
Health Insurance (subject to eligibility)
401(k) Matching after 1 year
Paychex Benefits including Payactiv access
✔️ Strong Company Culture: 93% employee retention (2+ years), great reviews, and supportive leadership.
✔️ Schedule: Monday–Friday, 9:00 AM–5:30 PM (Fully Remote).
✔️ Impact & Growth: Join a mission-driven team improving Medicaid care quality while advancing your career.
✅ Key Responsibilities
✔️ Conduct utilization and quality reviews, including appeals, chart screenings, and medical record assessments.
✔️ Perform final-level insurance appeals and review inpatient high-cost hospital stays using InterQual criteria.
✔️ Review and validate itemized bills; prepare written responses for hospitals.
✔️ Collect and analyze clinical study data and participate in collaborative training.
✔️ Support administrative staff through training and procedural guidance.
✅ Qualifications
✔️ Education: Graduate of an accredited nursing program.
✔️ Licensure: Active RN license and active NY State license.
✔️ Experience: 1–3 years in case review, utilization, billing, or coding review; InterQual and Milliman experience required.
✔️ Technical Skills: Proficiency with Microsoft Outlook, Word, and spreadsheets.
✔️ Soft Skills: Analytical mindset, attention to detail, and ability to work independently in a remote setting.
Apply Now
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