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Skills
Analysis Skillsunmatched
Clinical Nursingunmatched
Electronic Medical Recordsunmatched
Health Insuranceunmatched
Legalunmatched
Legal Appealsunmatched
Nonprofitunmatched
Nursing Credentialsunmatched
Patient Careunmatched
Presentation/Verbal Skillsunmatched
Problem Solving Skillsunmatched
Registered Nurse (RN)unmatched
Regulationsunmatched
Reimbursementunmatched
Staff Trainingunmatched
Team Playerunmatched
Technical Supportunmatched
Time Managementunmatched
Training Programunmatched
Utilization Managementunmatched
Writing Skillsunmatched
Description
Registered Nurse Clinical Reviewer (IDR) – Jericho, NY
Location: Jericho, NY Employment Type: Full-time Pay: $60/hour (based on experience)
Position Overview:
We are seeking a Registered Nurse Clinical Reviewer to join our team supporting a non-profit organization in Jericho, NY. This role is ideal for an experienced RN with a utilization review or appeals background who thrives in a collaborative, independent, and deadline-driven environment focused on independent dispute resolution (IDR).
Why You'll Love Working Here:
Competitive pay of $60/hour, based on experience.
1 week paid vacation after 3 months (2 weeks starting your second year).
6 major paid holidays per year (after 3 months).
5 sick days (40 hours), per the NYS Paid Sick Leave Act.
License reimbursement after 1 year.
Health insurance (subject to plan eligibility).
401(k) match eligibility after 1 year.
Additional benefits including Payactiv (earned wage access).
Strong culture and retention — 93% of our team stays 2+ years.
The opportunity to develop expertise in independent dispute resolution (IDR), medical-legal review, and appeals.
Meaningful work improving patient outcomes through fair, evidence-based clinical determinations.
Qualifications:
Baccalaureate degree in Nursing, or graduate of an approved Registered Professional Nurse training program.
Licensed as a Registered Professional Nurse in New York State.
1–3 years of experience in utilization review and/or appeals (required).
At least 3 years of experience in a med-legal review setting.
Knowledge of and experience with electronic medical records (EMR).
Ability to oversee, problem-solve, and work collaboratively with peers and medical, analytical, and administrative staff.
Excellent written and verbal communication.
Able to work independently with little supervision; flexible, innovative, and creative.
Able to meet deadlines in a time-sensitive environment.
Key Responsibilities:
Conduct reviews up to and including the appeal level — chart screens, compiling regulatory guidance, researching insurer requirements, completing electronic worksheets, and preparing final determinations.
Serve as a resource to administrative and clinical staff for training, problem-solving, and clarifying determinations; provide technical assistance and participate in staff huddles.