Clinical Reviewer (Remote) - Illinois

Join Our Team as a Clinical Reviewer and Make a Difference in Healthcare! We are seeking a highly skilled and motivated Clinical Reviewer to join our team in Illinois. As a Clinical Reviewer, you will play a critical role in reviewing assessments and clinical operations to ensure completeness, accuracy, and adherence to contract clinical standards. This is a remote position, offering a hybrid work model that combines the flexibility of working from home with the opportunity to collaborate with our team in our office.

This exciting opportunity offers a competitive salary, comprehensive benefits, and a dynamic work environment. If you are a results-driven professional with a strong clinical background and excellent communication skills, we encourage you to apply.

About the Program: We have partnered 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. Our program also includes Follow Up Visits, admissions support for Specialized Mental Health Rehabilitation Facilities (SMHRF) and Supported Living Programs (SLP) settings, and Colbert Dementia Review.

Why Maximus? We offer a comprehensive range of benefits, including:

• 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
• 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
• Diversity, Equity, and Inclusion Initiatives: Join a workplace committed to fostering diversity and inclusion
• 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 documentation and/or assessments and apply clinical criteria to complete determinations, approvals, or recommendations
• Determine need for and obtain any additional information required to complete actions
• Determine when escalation or consultation is required with supervisor, physician, or related medical or clinical discipline
• Complete reports or documentation in accordance with contract requirements
• Perform 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
• Excellent written and verbal communication skills
• Excellent interpersonal and customer service skills
• Proficient in Microsoft Office Suite
• Excellent organizational skills and attention to detail
• Ability to work in a fast-paced environment
• Ability to work independently and meet timelines

Minimum Requirements

• High School Degree or equivalent required
• Minimum 1 year of clinical experience required
• LPN, RN, LCSW, or related licensure preferred and may be required based on contract requirements
• Masters degree in psychology, sociology, counseling, social work, nursing, or other mental health-related field required
• 2 years experience in mental health, social services, or related field required
• 2 years experience reviewing clinical assessments required

Preferred Requirements

• Experience with PASRR, SMHRF, and SLP preferred

EEO Statement: Maximus is an Affirmative Action/Equal Opportunity Employer. We provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disabled status.

Pay Transparency: Maximus compensation is based on various factors, including job location, education, training, experience, and 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.

Hourly Base Pay: $22.26 - $29.71 per hour

Remote: Yes

Take the Next Step

Are you ready for this challenge? Apply now and let's discuss how you can become a vital part of our success story.