Clinical Reviewer, RN / LPN (Remote)

Maximus; Portland (OR); Remote; USD 80,000 - 100,000; Full time

Job summary

A leading company is seeking a detail-oriented Clinical Reviewer, RN / LPN to support multiple programs remotely. In this role, you'll review Preadmission Screening and Resident Review (PASRR) screens and make clinical decisions regarding long-term care placements. The ideal candidate must possess an active nursing license and relevant clinical experience, ensuring effective service delivery within mental health and long-term care settings.

Benefits

Competitive Compensation with bonuses

Comprehensive Insurance Coverage

401K Retirement Savings plan and Company Matching

Paid Time Off Package

Tuition Reimbursement

Recognition Platform

Holistic Wellness Support

Qualifications

• Hold an active and unrestricted license as a Registered Nurse (RN) or Licensed Practical Nurse (LPN).
• Minimum 1 year of clinical experience required.
• Minimum of 3 years experience in the behavioral or mental health field.

Responsibilities

• Review requests for services including admission, discharges, and continued stays.
• Issue approvals, denials, or recommendations based on contract requirements.
• Complete documentation of activities within contract systems.

Skills

Clinical assessment

Data collection

Problem-solving

Education

High School Degree or equivalent

Job description

Description & Requirements Maximus is seeking a detail-oriented Clinical Reviewer, RN / LPN to support the Connecticut PASRR Program and multiple other programs. In this position, you will act in a floating capacity between programs and be responsible for reviewing Level I PASRR screens and making clinical decisions regarding the appropriateness of long-term care (LTC) placement. This role is 100% remote with no travel or on-site requirements.

About the Program

We partner with the Department of Social Services to perform Preadmission Screening and Resident Review (PASRR) for individuals applying to or residing in Medicaid-certified nursing homes. The primary goal of this federally mandated assessment is to determine whether the nursing home is the appropriate placement for individuals with mental illness, intellectual disabilities, or developmental disabilities. PASRR also helps match individuals with the care and services they need.

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, 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 the job posting.
• High School Degree or equivalent required.
• Minimum 1 year of clinical experience required.
• Minimum of 3 years of experience in the behavioral or mental health field.
• Hold an active and unrestricted license as a Registered Nurse (RN) or Licensed Practical Nurse (LPN).

Preferred Requirements

• Prior experience with PASRR assessments.
• Prior experience reviewing mental health or medical assessments.

Home Office Requirements

• Reliable high-speed internet service (minimum 20 Mbps download, 50 Mbps shared, 5 Mbps upload).
• Company-issued computer equipment.
• Private and secure workspace.

#ClinicalServices #LI-Remote

EEO & Pay Transparency

Maximus is an equal opportunity employer. Compensation is based on various factors including education, experience, and market conditions. Salary ranges are between $22.00 and $30.00 per hour.