Clinical Reviewer - Remote

Maximus; Tucson (AZ); Remote; USD 60,000 - 80,000; Full time

Job summary

Maximus is seeking a Clinical Reviewer to support the Illinois SALT program. This remote position involves conducting assessments and evaluations for individuals in Medicaid-certified facilities. The role requires effective communication skills and a background in mental health, offering flexibility with a schedule of four days per week.

Benefits

Competitive Compensation - Bonuses based on performance

Comprehensive Insurance Coverage

401K Retirement Savings plan with Company Matching

Paid Time Off Package - PTO, Holidays, and Sick Leave

Holistic Wellness Support through an Employee Assistance Program

Tuition Reimbursement for ongoing education

Professional Development Opportunities

Qualifications

• Minimum 1 year of clinical experience required.
• Minimum 2 years post-graduate experience in the mental health field.
• Experience conducting mental health assessments.

Responsibilities

• Review requests for services for adherence to clinical criteria.
• Issue approvals, denials, or recommendations based on contract requirements.
• Complete documentation of activities within contract systems.

Skills

Interpersonal skills

Communication skills

Data collection

Problem-solving

Knowledge of medical diagnoses

Knowledge of behavioral health diagnoses

Education

High School Degree or equivalent

Master's degree in Social Work, Mental Health, or related field

Tools

Microsoft Office

Job description

Description & Requirements Maximus is hiring a Clinical Reviewer to support the Illinois SALT program. The Clinical Reviewer is responsible for evaluating assessments and making determinations regarding individuals' needs for additional supports and services. This is a remote position and follows a schedule of four 10-hour days, Thursday through Sunday. About the program : We have contracted with the State of Illinois Department of Healthcare and Family Services (HFS) to manage the assessment process for Preadmission Screening and Resident Review (PASRR) Level I screens and completing Level II Serious Mental Illness (SMI) evaluations for individuals applying to, or residing in, Medicaid-certified nursing facilities. Other services include Follow Up Visits, admissions support for Specialized Mental Health Rehabilitation Facilities (SMHRF) and Supported Living Programs (SLP) settings and Colbert Dementia Review. Continues to expand assessment services in the state. Why Maximus? - Work / Life Balance Support - Flexibility tailored to your needs! -

• Competitive Compensation - Bonuses based on performance included! -
• Comprehensive Insurance Coverage - Choose from various plans, including Medical, Dental, Vision, Prescription, and partially funded HSA. Additionally, enjoy Life insurance benefits and discounts on Auto, Home, Renter's, and Pet insurance. -
• Future Planning - Prepare for retirement with our 401K Retirement Savings plan and Company Matching. -
• Paid Time Off Package - Enjoy PTO, Holidays, and extended sick leave, along with Short and Long Term Disability coverage. -
• Holistic Wellness Support - Access resources for physical, emotional, and financial wellness through our Employee Assistance Program (EAP). -
• Recognition Platform - Acknowledge and appreciate outstanding employee contributions. -
• Tuition Reimbursement - Invest in your ongoing education and development. -
• Employee Perks and Discounts - Additional benefits and discounts exclusively for employees. -
• Maximus Wellness Program and Resources - Access a range of wellness programs and resources tailored to your needs. -
• Professional Development Opportunities-Participate in training programs, workshops, and conferences. -
• Licensures and Certifications-Maximus assumes the expenses associated with renewing licenses and certifications for its employees. Essential Duties and Responsibilities : - Review requests for services including admission, discharges and continued stays for adherence to clinical criteria, state and federal policy, and related requirements. - Issue approvals, denials or recommendations based on contract requirements. - Identify need for additional clinical documentation or consultation. - Complete documentation of activities within contract systems. - Communicate with providers, individuals and their designees, or state workers as required. - Performs other related duties as assigned. Required Skills / Abilities : - Preferred knowledge may include community support programs, long-term care assessment and level of care in medical, behavioral health or related programs - Knowledge and understanding of medical and / or behavioral health diagnoses and prescribed medications - Ability to collect data, define problems, establish facts, and draw valid conclusions Minimum Requirements - Education and licensure requirements are based on program contract requirements and are outlined in job posting - High School Degree or equivalent required - Minimum 1 year of clinical experience required - Master's degree in Social Work, Mental Health, or a related field OR an active and unrestricted Nursing license . - Minimum 2 years post-graduate work experience in the mental health field - Minimum 2 years experience conducting mental health assessments - Outstanding interpersonal and verbal communication skills - Strong proficiency in written communication, with the ability to produce concise and impactful clinical documentation - Highly skilled using Microsoft office Preferred Requirements - Experience conducting PASRR assessments Home Office Requirements - Maximus provides company-issued computer equipment - Reliable high-speed internet service - Minimum 20 Mpbs download speeds / 50 Mpbs for shared internet connectivity - Minimum 5 Mpbs upload speeds - Private and secure workspace #ClinicalServices #LI-Remote EEO Statement Maximus is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics. Pay Transparency Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. Annual salary is just one component of Maximus's total compensation package. Other rewards may include short- and long-term incentives as well as program-specific awards. Additionally, Maximus provides a variety of benefits to employees, including health insurance coverage, life and disability insurance, a retirement savings plan, paid holidays and paid time off. Compensation ranges may differ based on contract value but will be commensurate with job duties and relevant work experience. An applicant's salary history will not be used in determining compensation. Maximus will comply with regulatory minimum wage rates and exempt salary thresholds in all instances. Minimum Salary $ 27.00 Maximum Salary $ 29.00