ISLAND PEER REVIEW ORGANIZATION INC·Jericho, New York
The Clinical Reviewer conducts utilization and quality reviews, including chart screening and data collection for clinical studies. They also provide technical assistance and training to administrative staff while supporting medical review analysts and physician consultants.
As a Clinical Reviewer (RN), you will complete the full spectrum of activities related to Utilization or Quality reviews as assigned. You will utilize your knowledge and expertise of the review program to conduct clinical level review, supporting Medical Review Analysts, and Physician Consultants to ensure an appropriate and accurate process. Duties include but are not limited to:
Conduct utilization reviews up to and including the appeal level. This includes chart screen, complete electronic worksheets, enter required information and make level one denial decisions when necessary.
Conduct quality and clinical study data collection reviews. This includes chart review, complete detailed electronic data worksheets.
Act as a resource for the administrative staff in training, problem solving, and clarifying procedures. Will provide technical assistance and conduct/participate in staff huddles.
Participate in collaborative training specific to clinical study objectives.
This position is office based at our Jericho, NY office.
The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. The hourly rate for this position is $38.46 - $43.27. Actual salary and/or hourly rate depends on a variety of factors including experience, education, credentials, location, and budget.
The salary range and/or hourly rate listed does not include other forms of compensation or benefits.
IPRO is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or military status, or any other category protected under applicable law.
Candidates must be a New York State Licensed Registered Nurse with a bachelor's degree in nursing or equivalent professional training. A minimum of two years of acute care experience or one to three years of acute care utilization review experience is required.
Market context
In New York, nursing roles like LPN positions are commonly driven by ongoing staffing needs in hospitals, long-term care, and behavioral health settings. Competition can be stronger for roles that prefer mental health, alcoholism, or chemical addiction experience, so a valid New York State LPN license and accredited nursing education matter. Review the AI-summarized requirements and benefits on this platform to save research time, then tailor your application to highlight any relevant behavioral health experience.
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