Clinical Reviewer (RN)
Company: ISLAND PEER REVIEW ORGANIZATION INC
Location: Jericho
Posted on: February 14, 2026
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Job Description:
Job Description Job Description As the Clinical Reviewer, you
will be responsible for the review and processing of all requests
for Independent Reviews from External Agencies in accordance with
contractual guidelines. Upon receipt of the electronic medical
records, communicate with contractors, providers and
beneficiary/representatives. Duties include but are not limited to:
Performing case reviews utilizing regulatory guidelines criteria
and clinical knowledge for medical necessity and quality of care
issues; formulate a case summary and the review questions for the
Physician Reviewer based upon the External Agency’s concern(s),
reviewing physician determinations, ensuring all categories of
concern have been addressed and preparing written correspondences
to contractors, providers and beneficiaries/representatives. This
is a full-time position based in the Jericho, NY office. Ability to
work remotely one day per week after introduction period .
QUALIFICATIONS: The ability to interact with providers,
internal/external customers and representatives. Excellent
communication skills (both verbal and writing) with a professional
demeanor The ability to work independently, as well as in a team
environment. Excellent time management/ prioritization skills to
meet contractual deadlines while maintaining a high level of
quality work to meet customer satisfaction and standards. Strong
clinical critical thinking skills Advanced skills and knowledge of
standard EHR applications, office technology and Microsoft
applications including Word, Excel, and PowerPoint. Ability to
handle sensitive and confidential information. EDUCATION &
EXPERINCE: Licensed Registered Nurse, required (open to any RN
state license). Graduate of a School of Nursing, required. Bachelor
of Science in Nursing (BSN), required A minimum of three (3) years
clinical experience in an acute care setting or related experience,
required. Experience in utilization and quality reviews, required.
Experience in managed care, quality management and peer review,
preferred. 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 range for this position is $38.46 – $43.27. Actual salary
range 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, age, national origin,
disability, protected veteran status or military status, or any
other category protected under applicable law.
Keywords: ISLAND PEER REVIEW ORGANIZATION INC, Levittown , Clinical Reviewer (RN), Healthcare , Jericho, New York
