Registered Nurse, Clinical Reviewer
Greenlife Healthcare Staffing
Posted: 10/22/2026
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Greenlife Healthcare StaffingCore Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in Utilization and Quality Reviews, with a strong background in clinical-level review and electronic medical records. Proficient in conducting chart reviews, data entry, and collaborating with medical and administrative staff to ensure accurate processes.
Highest-signal resume keywords
Registered Professional Nurse LicenseUtilization Review ExperienceElectronic Medical Records (EMR) ProficiencyInterQual and Milliman (MCG) Criteria KnowledgeAttention to Detail
About the role
Key responsibilities & impact- Complete the full spectrum of activities related to Utilization or Quality reviews as assigned
- Utilize review-program knowledge and expertise to conduct clinical-level review
- Support Medical Review Analysts and Physician Consultants to ensure an appropriate and accurate process
- Conduct utilization reviews up to and including the appeal level
- Screen charts, complete electronic worksheets, enter required information, and make level-one denial decisions when necessary
- Conduct quality and clinical study data collection reviews
- Complete chart reviews and detailed electronic data worksheets
- Act as a resource for administrative staff in training, problem-solving, and clarifying procedures
- Provide technical assistance and conduct or participate in staff huddles
- Participate in collaborative training specific to clinical study objectives
- Perform other necessary activities as assigned
Requirements
What you’ll need- Baccalaureate degree in Nursing or graduate of an approved Registered Professional Nurses training program
- Licensed as a Registered Professional Nurse in New York State
- Minimum of two (2) years of experience in an acute care facility, preferably in medicine/surgery or special care units; and/or one to three (3) years of experience in acute care utilization review
- Knowledge and experience with electronic medical records (EMR), including utilization, quality, and clinical charting
- Experience with InterQual and Milliman (MCG) criteria
- Proficiency in completing electronic worksheets and data entry
- Ability to oversee, problem-solve, and work collaboratively with peers, medical, analytical, and administrative support staff
- Excellent written and verbal communication skills
- Ability to work independently with little supervision
- Ability and desire to be flexible, innovative, and creative
- Strong attention to detail and ability to meet deadlines in a time-sensitive environment
Benefits
Comp & perks- 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
- 5 Sick Days (40 Hours) subject to the provisions of the 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
- 93% retention of employees 2 years+
- Remote work flexibility
- Professional growth in utilization review, quality improvement, and clinical study data collection
- Supportive non-profit environment
- Mission-driven work contributing to improved patient outcomes
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Clinical-Level ReviewChart ReviewData EntryUtilization ReviewQuality ReviewElectronic Worksheets CompletionAppeal Level ReviewClinical Study Data CollectionMedical Review SupportDecision-Making
Soft Skills
Excellent Written CommunicationExcellent Verbal CommunicationProblem-SolvingCollaborationFlexibility
Certifications & Qualifications
Baccalaureate Degree in Nursing
Industry Keywords
Acute Care FacilityMedicine/SurgerySpecial Care UnitsClinical ReviewQuality Assurance