Greenlife Healthcare Staffing Permanent Jobs

Back to All Jobs Registered Nurse/ Medicaid Clinical Reviewer GreenLife Healthcare Staffing - New York, NY, United States Registered Nurse/Medicaid Clinical Reviewer - Remote (#25298A)

Location:

Remote Employment Type:

Full-time Hourly Rate:

$50/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:

We are seeking an experienced Registered Nurse to join our team as a Medicaid Clinical Reviewer. This fully remote position involves conducting clinical reviews for Medicaid cases, ensuring compliance with state regulations, and contributing to quality improvement initiatives for a respected non-profit organization. Why Join Us?

Competitive Compensation:

Earn $45-$50 per hour based on experience

Comprehensive Benefits:

Paid Vacation based on accruals 6 Major Paid Holidays per year 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 401k 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

Work Schedule:

Full-time, Monday to Friday (9:00 AM - 5:30 PM),

Fully Remote Professional Growth:

Gain valuable experience in a collaborative, innovative, and supportive environment

Impactful Work:

Contribute to a mission-driven organization dedicated to improving patient outcomes through quality Medicaid program oversight

Qualifications:

Education:

Graduate of an accredited nursing program

Licensure:

Active RN State license and active

NY State License Experience:

1-3 years of experience in Case Review, Utilization, Billing, and coding review; InterQual and Milliman experience required

Technical Skills:

Proficiency with Microsoft Outlook, Word, and spreadsheets; comfortable working extensively on computer systems

Soft Skills:

Strong analytical skills, attention to detail, and ability to work independently in a remote environment

Key Responsibilities:

This individual will complete the full spectrum of activities related to Medicaid Utilization or Quality reviews as assigned. Thus, conduct final level insurance appeals and review medical records. Responsibilities for Registered Nurse/Medicaid Clinical Reviewer - Remote Conduct utilization reviews up to and including the appeal level. This includes chart screen, completing electronic worksheets, entering the required information, and making level one denial decisions when necessary. Conduct quality and clinical study data collection reviews. Act as a resource for the administrative staff in training, problem-solving, and clarifying procedures. Participate in collaborative training specific to clinical study objectives. You will be using InterQual criteria to review the medical records of inpatient high cost hospital stays for admission and acute level of care. You'll also review and validate itemized bills and need to have the ability to write up responses to send to the hospital. Other activities as may be deemed necessary How to

Apply:

If you are an experienced RN with Medicaid or clinical review experience, ready to take the next step in your nursing career, 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 and others we offer. Greenlife Healthcare Staffing - Empowering Healthcare Professionals, Enriching Lives.

Posted:

Monday, March 30, 2026 Job # 24827 Apply Now Share Back to All Jobs