IDR/IIDR Reviewer – Contingent

iMPROve Health

. Complete IDR/IIDR case reviews in accordance with contract requirements and deadlines .

Posted 9/17/2026part-timeRemote • United StatesMid-LevelSenior💰 $34 - $42 per hourWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in case management and utilization review within healthcare settings, ensuring compliance with HIPAA, FISMA, URAC, and CMS standards while effectively managing timelines and deliverables.

Highest-signal resume keywords

Utilization Review ExperienceCase Management SkillsKnowledge of Healthcare RegulationsStrong Analytical SkillsProficiency in Microsoft Office

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Data EntryCase ReviewCompliance ManagementProblem-SolvingDocumentation DraftingAnalytical SkillsOrganizational SkillsJudgment ApplicationTimeline DevelopmentQuality Assurance

Soft Skills

Effective CommunicationAttention to DetailFlexibilityTime ManagementDecision-Making

Tools & Technologies

CMS SystemsMicrosoft WordMicrosoft ExcelMicrosoft OutlookMicrosoft PowerPointMicrosoft AccessMicrosoft Visio

Certifications & Qualifications

Nursing LicensureSocial Work Licensure

Industry Keywords

Long-Term CareAssisted LivingICF/IID FacilitiesHealthcare SettingsConflict of Interest ManagementFederal RegulationsState RegulationsLife Safety CodesCMS Surveyor TrainingURAC Standards

About the role

Key responsibilities & impact

Complete IDR/IIDR case reviews in accordance with contract requirements and deadlines
Manage assigned deliverables, ensuring accuracy, quality, and timeliness
Develop and monitor timelines and work plans for assigned cases
Perform accurate and timely data entry into CMS systems and internal databases
Process and manage incoming and outgoing Conflict of Interest (COI) case reviews
Securely handle and transmit sensitive case information
Maintain compliance with HIPAA, FISMA, URAC, and CMS standards
Proactively identify and resolve issues affecting timelines or deliverables
Communicate with internal teams and stakeholders
Perform other duties as assigned

Requirements

What you’ll need

Experience in long-term care, assisted living, ICF/IID facilities, or related healthcare settings
Knowledge of state and federal regulations governing healthcare facilities and services
Experience with utilization review, case management, or healthcare review processes preferred
Background in nursing, social work, life safety codes, or CMS surveyor training highly desirable
Strong analytical, problem-solving, and organizational skills
Ability to manage multiple priorities and meet deadlines
Bachelor’s degree or equivalent experience in utilization review, case management, or healthcare field required
Nursing or related licensure preferred but not required
Relevant healthcare, utilization review, or case management experience preferred
Strong written and verbal communication skills
Ability to clearly present complex or technical information
Skilled at drafting concise, accurate documentation
Proficiency in Microsoft Office (Word, Excel, Outlook)
Working knowledge of PowerPoint, Access, and Visio preferred
Ability to analyze complex cases and apply sound judgment
Strong attention to detail and accuracy
Effective problem-solving and decision-making skills
Availability on an as-needed basis for up to 10 hours per week
Flexibility to accept assignments as needed and meet established deadlines and turnaround requirements

Benefits

Comp & perks

100% remote work from anywhere in the United States
Work/life balance
Professional development opportunities
Continuing education opportunities