Registered Nurse Clinical Reviewer- IDR | Jericho, NY

Job description

Registered Nurse Clinical Reviewer / IDR / Jericho, NY 11753 (#25154C)

Location: Jericho, New York 11753
Employment Type: Full-time
Pay Rate: $60/hour (based on experience)

Position Overview
We are seeking an experienced Registered Nurse Clinical Reviewer (IDR) to perform utilization review and appeals in a non-profit organization in Jericho, NY. This role focuses on independent dispute resolution, medical-legal review, and evidence-based clinical determinations.

Why Join Us
✔️ $60/hour competitive pay
✔️ Paid vacation, holidays, and sick leave
✔️ Health insurance + 401(k) match (after 1 year)
✔️ License reimbursement
✔️ Exposure to IDR and medical-legal review
✔️ Collaborative, mission-driven environment

Qualifications
✔️ Active New York State RN License
✔️ Bachelor’s degree in Nursing (or equivalent)
✔️ 1–3 years utilization review and/or appeals experience
✔️ Minimum 3 years Med-Legal review experience
✔️ EMR proficiency
✔️ Strong analytical, writing, and communication skills
✔️ Ability to work independently and meet deadlines

Key Responsibilities
✔️ Conduct utilization reviews and appeals (including IDR cases)
✔️ Review charts, analyze clinical data, and prepare determinations
✔️ Research payer guidelines and regulatory requirements
✔️ Complete electronic review documentation and reports
✔️ Provide guidance and support to clinical and admin teams
✔️ Participate in training, case discussions, and process improvements

• License Reimbursement after 1 year of employment
• 401(k) Matching eligibility after 1 year of employment
• 1 Week of Paid Vacation based on accruals after 3 months of employment