Clinical Reviewer - (Remote)
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 related degree program - Minimum of two (2) years post-graduate work experience in the mental health field - Minimum of two (2) years experience conducting mental health assessments - Proficiency in Microsoft office Applications Preferred Requirements: - Demonstrates outstanding interpersonal and verbal communication skills - Demonstrates strong proficiency in written communication, producing concise and impactful documentation - IM+CANS certification or willingness to obtain IM+CANS certification - Strong computer skills - Knowledgeable about PASRR Home Office Requirements: - Maximus provides company-issued computer equipment - Reliable high-speed internet service - Minimum 20 Mbps download speeds/50 Mbps for shared internet connectivity - Minimum 5 Mbps 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. Accommodations Maximus provides reasonable accommodations to individuals requiring assistance during any phase of the employment process due to a disability, medical condition, or physical or mental impairment. If you require assistance at any stage of the employment process-including accessing job postings, completing assessments, or participating in interviews,-please contact People Operations at [email protected]. Minimum Salary $ 25.07 Maximum Salary $ 30.67
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