Registered Nurse Clinical Reviewer (IDR)
Jericho, New York•Full-time
$60+ hourly
$60+ hourly
About the Job
Registered Nurse Clinical Reviewer (IDR) – Jericho, NY
Location: Jericho, NY
Employment Type: Full-time
Pay: $60/hour (based on experience)
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.
- Participate in collaborative training.
- Other activities as needed.