Job Description

Maximus is hiring a Clinical Reviewer to review assessments and clinical operations for completeness, accuracy, and adherence to contract clinical standards. The Clinical Reviewer will complete reports, recommendations, or eligibility determinations based on contract clinical standards.

• This is a remote position requiring residency in the state of Illinois with a Thursday - Sunday schedule, working 10 hour days from 8:00 am to 6:30 pm CST*

About the program: We have contracted 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 for individuals applying to, or residing in, Medicaid-certified nursing facilities. Other services include Follow Up Visits, admissions support for Specialized Mental Health Rehabilitation Facilities (SMHRF) and Supported Living Programs (SLP) settings and Colbert Dementia Review. Continues to expand assessment services in the state.

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.
• 🌈 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:

• Responsible for reviewing documentation and/or assessments and applying 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 related clinical discipline.
• Complete reports or documentation in accordance with contract requirements.
• 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
• 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

• 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
• 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

Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce. We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a difference for our country. We’re proud of our connections to organizations dedicated to serving veterans and their families. If you are transitioning from military to civilian life, have prior service, are a retired veteran or a member of the National Guard or Reserves, or a spouse of an active military service member, we have challenging and rewarding career opportunities available for you. A committed and diverse workforce is our most important resource. Maximus is an Affirmative Action/Equal Opportunity Employer. Maximus provides 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 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.

Hourly Base Pay Minimum for this Position

$22.26

Hourly Base Pay Maximum for this Position

$29.71

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