Remote LPN Clinical Reviewer – PASRR Level I

Christus Health; Boyce (LA); Remote; USD 65,000 - 90,000; Full time

Benefits offered by this job

Comprehensive health insurance

401K with match

Paid time off (PTO)

Tuition reimbursement

Life insurance

Employee assistance program

Job summary

Maximus seeks a Clinical Reviewer (LPN) to support Illinois PASRR Level I screenings in a fully remote role. You will review clinical documentation, coordinate with providers, determine if Level II SMI evaluations are needed, and ensure HIPAA compliance while supporting long-term care admissions and reviews.

Qualified LPNs with strong clinical judgment and attention to detail will assess cases, write substantiated determinations, and collaborate with a clinical team to improve healthcare

Qualifications

• High School Diploma or equivalent required.
• Licensed Practical Nurse (LPN) license in Illinois or a Compact license is required.
• Minimum 2 years of experience in Medical Nursing and/or Mental Health.
• Proficiency in MS Office applications (Outlook, Excel, PowerPoint, Word).

Responsibilities

• Review requests for services, including admissions, discharges, and continued stays for adherence to clinical criteria and policy.
• Issue approvals, denials, or recommendations based on contract requirements.
• Identify need for additional clinical documentation or consultation and analyze information gaps.
• Complete accurate documentation of review activities within contract systems.
• Communicate with providers, individuals and their designees, or state workers as required.

Skills

Effective communication

MS Office

Education

High School Diploma or equivalent

LPN license (IL or Compact)

Tools

MS Office (Outlook/Excel/PowerPoint/Word)

Job description

Maximus seeks a Clinical Reviewer (LPN) to support Illinois PASRR Level I screenings in a fully remote role. You will review clinical documentation, coordinate with providers, determine if Level II SMI evaluations are needed, and ensure HIPAA compliance while supporting long-term care admissions and reviews.

Qualified LPNs with strong clinical judgment and attention to detail will assess cases, write substantiated determinations, and collaborate with a clinical team to improve healthcare