Remote LPN Clinical Reviewer – PASRR & Care Decisions

Christus Health; Glenmora (LA); Remoto; USD 55.000 - 60.000; Tempo pieno

Vantaggi offerti da questo lavoro

Bonuses based on performance

401K Retirement Savings

Medical, Dental, Vision Insurance

Paid Time Off (PTO)

Tuition Reimbursement

Discounts on insurance

Descrizione del lavoro

Maximus is seeking a Clinical Reviewer (LPN) to support Illinois PASRR Level I screenings in a fully remote role. You will review clinical documentation, coordinate with providers, and ensure HIPAA compliance.

You will collaborate with a clinical team to monitor screening activities, identify needs for additional evaluation, and contribute to quality outcomes for nursing facility residents.

Competenze

• Current and active Licensed Practical Nurse (LPN) license in Illinois or a Compact license.
• Minimum 2 years of Medical Nursing and/or Mental Health experience.
• Proficiency in MS Office Applications such as Outlook, Excel, PowerPoint, and Word

Mansioni

• Review requests for admissions, discharges, and continued stays for adherence to clinical criteria, state and federal policy, and contract requirements.
• Issue approvals, denials, or recommendations based on contract requirements, applying judgment and analysis to interpret guidelines in non-routine cases.
• Identify the need for additional clinical documentation or consultation and analyze information gaps to support accurate and timely determinations.
• Complete accurate documentation of review activities within contract systems.
• Communicate with providers, individuals and their designees, or state workers as required.

Conoscenze

LPN License

Clinical Nursing

MS Office

Formazione

LPN License (IL or Compact)

Strumenti

MS Office Suite

Descrizione del lavoro

Maximus is seeking a Clinical Reviewer (LPN) to support Illinois PASRR Level I screenings in a fully remote role. You will review clinical documentation, coordinate with providers, and ensure HIPAA compliance.

You will collaborate with a clinical team to monitor screening activities, identify needs for additional evaluation, and contribute to quality outcomes for nursing facility residents.