# Registered Nurse/Medicaid Clinical Reviewer

> Greenlife Healthcare Staffing · New York, United States (Remote) · Full-time · Posted 2026-05-05

**Salary:** USD 100,000–104,000

**Workplace:** remote

**Department:** Lisa

## Description

**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?**

-   **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

**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

**Greenlife Healthcare Staffing - Empowering Healthcare Professionals, Enriching Lives.**

## Requirements

**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. Must have at least 2 years of Med/Surg experience.
-   **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

## Benefits

-   **Competitive Compensation:** Earn $45-$50 per hour based on experience
-   **Comprehensive Benefits:**

-   1 Week 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

## Apply

[Apply at Greenlife Healthcare Staffing](https://apply.workable.com/greenlife-healthcare-staffing-1/j/3DF507D3E3/apply)

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