Registered Nurse Clinical Reviewer / IDR – Jericho, NY
Location: Jericho, NY Employment Type: Full-time Rate: $60/hour (based on experience)
Position Overview:
We are seeking a Registered Nurse Clinical Reviewer / IDR to join a non-profit organization located in Jericho, New York. 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.
Why You'll Love Working Here:
Competitive rate of $60/hour based on experience.
1 week of paid vacation based on accruals after 3 months of employment (2 weeks with accrual starting your second year).
6 major paid holidays per year (after 3 months of employment).
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, subject to plan eligibility requirements.
401(k) matching eligibility after 1 year of employment.
Additional benefits such as Payactiv.
Full-time position.
Valuable experience in independent dispute resolution (IDR), medical-legal review, and appeals within a supportive non-profit setting.
Mission-driven work improving patient outcomes through fair, evidence-based clinical determinations.
Qualifications:
Baccalaureate degree in Nursing, or graduate of an approved Registered Professional Nurses 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 and experience with electronic medical records (EMR).
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.
Flexibility, innovation, and creativity.
Ability to meet deadlines in a time-sensitive environment.
Key Responsibilities:
Conduct reviews up to and including the appeal level, including chart screens, compiling regulatory guidance, researching insurer requirements, completing electronic worksheets, and preparing final determinations.
Act as a resource for administrative and clinical staff in training, problem-solving, and clarifying determinations; provide technical assistance and conduct/participate in staff huddles.
Participate in collaborative training.
Other activities as needed.
Numbers & Facts
Location
Jericho, New York
Salary
$60
Skills
Administrative Skillsunmatched
Analysis Skillsunmatched
Clinical Nursingunmatched
Communication Skillsunmatched
Electronic Medical Recordsunmatched
Health Insuranceunmatched
Legalunmatched
Legal Appealsunmatched
Nonprofitunmatched
Nursing Credentialsunmatched
Patient Careunmatched
Presentation/Verbal Skillsunmatched
Problem Solving Skillsunmatched
Process Improvementunmatched
Registered Nurse (RN)unmatched
Regulationsunmatched
Staff Trainingunmatched
Team Playerunmatched
Technical Supportunmatched
Time Managementunmatched
Training Programunmatched
Utilization Managementunmatched
Writing Skillsunmatched
🎯
Be found by employers
5,500+ employers search our resume database daily. Add yours to get found by recruiters looking for candidates like you.
Level up your application
Professional resume templates
Browse dozens of recruiter approved resume templates, layouts and formats. Choose your favorite and make it your own in minutes.