Sr. Clinical Review Coordinator - RN (Remote)

Description & Requirements

Maximus is hiring a Clinical Review Coordinator - RN (Remote) to support the OR MED program.

The Clinical Review Coordinator will review assessments for quality and review medical records and other documentation as needed.



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*This is a fully remote position that requires Oregon licensure.

About the program: We partner with Oregon DHS to manage in-person eligibility reviews for people that may be experiencing mental illness along with possible physical needs for the Aging and People with Disabilities (APD) Program.

Through the mental or emotional disorders (MED) Review process, we give DHS accurate review recommendations of an individual's primary need for services.

Our assessment enables DHS to make informed program eligibility decisions based on a clear and accurate understanding of which programs may best address an individual's unique needs.

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:

- 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.
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