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Description & Requirements
Maximus is seeking a Clinical Reviewer (Registered Nurse) to support the Tennessee (TN) Appeals area of the contract.
In this role, the RN Clinical Reviewer is responsible for reviewing clinical cases, applying nursing judgment and regulatory guidelines, and ensuring each case is accurately assessed and routed to the appropriate department or escalated as needed.
This position plays a critical role in maintaining compliance, supporting timely appeal resolutions, and ensuring high-quality, clinically sound decision-making.
About the Program:Tennessee Long-Term Services and Supports (TN LTSS) refers to a coordinated system of programs and services designed to assist individuals who have chronic illnesses, disabilities, or functional limitations and need ongoing support to live as independently and safely as possible.
TN LTSS includes a range of home- and community-based services (HCBS) and institutional care options that help individuals with activities of daily living, medical needs, and personal care, while prioritizing care in the least restrictive setting.
The program supports older adults and individuals with physical, intellectual, or developmental disabilities through person-centered planning that promotes dignity, independence, and quality of life.
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.
- • 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 co...
....Read more...
Type: Permanent Location: Morgantown, US-WV
Salary / Rate: Not Specified
Posted: 2025-12-27 07:29:45
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Description & Requirements
Maximus is seeking a Clinical Reviewer (Registered Nurse) to support the Tennessee (TN) Appeals area of the contract.
In this role, the RN Clinical Reviewer is responsible for reviewing clinical cases, applying nursing judgment and regulatory guidelines, and ensuring each case is accurately assessed and routed to the appropriate department or escalated as needed.
This position plays a critical role in maintaining compliance, supporting timely appeal resolutions, and ensuring high-quality, clinically sound decision-making.
About the Program:Tennessee Long-Term Services and Supports (TN LTSS) refers to a coordinated system of programs and services designed to assist individuals who have chronic illnesses, disabilities, or functional limitations and need ongoing support to live as independently and safely as possible.
TN LTSS includes a range of home- and community-based services (HCBS) and institutional care options that help individuals with activities of daily living, medical needs, and personal care, while prioritizing care in the least restrictive setting.
The program supports older adults and individuals with physical, intellectual, or developmental disabilities through person-centered planning that promotes dignity, independence, and quality of life.
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.
- • 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 co...
....Read more...
Type: Permanent Location: Burlington, US-VT
Salary / Rate: Not Specified
Posted: 2025-12-27 07:29:44
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Description & Requirements
Maximus is seeking a Clinical Reviewer (Registered Nurse) to support the Tennessee (TN) Appeals area of the contract.
In this role, the RN Clinical Reviewer is responsible for reviewing clinical cases, applying nursing judgment and regulatory guidelines, and ensuring each case is accurately assessed and routed to the appropriate department or escalated as needed.
This position plays a critical role in maintaining compliance, supporting timely appeal resolutions, and ensuring high-quality, clinically sound decision-making.
About the Program:Tennessee Long-Term Services and Supports (TN LTSS) refers to a coordinated system of programs and services designed to assist individuals who have chronic illnesses, disabilities, or functional limitations and need ongoing support to live as independently and safely as possible.
TN LTSS includes a range of home- and community-based services (HCBS) and institutional care options that help individuals with activities of daily living, medical needs, and personal care, while prioritizing care in the least restrictive setting.
The program supports older adults and individuals with physical, intellectual, or developmental disabilities through person-centered planning that promotes dignity, independence, and quality of life.
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.
- • 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 co...
....Read more...
Type: Permanent Location: Tysons, US-VA
Salary / Rate: Not Specified
Posted: 2025-12-27 07:29:44
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Description & Requirements
Maximus is seeking a Clinical Reviewer (Registered Nurse) to support the Tennessee (TN) Appeals area of the contract.
In this role, the RN Clinical Reviewer is responsible for reviewing clinical cases, applying nursing judgment and regulatory guidelines, and ensuring each case is accurately assessed and routed to the appropriate department or escalated as needed.
This position plays a critical role in maintaining compliance, supporting timely appeal resolutions, and ensuring high-quality, clinically sound decision-making.
About the Program:Tennessee Long-Term Services and Supports (TN LTSS) refers to a coordinated system of programs and services designed to assist individuals who have chronic illnesses, disabilities, or functional limitations and need ongoing support to live as independently and safely as possible.
TN LTSS includes a range of home- and community-based services (HCBS) and institutional care options that help individuals with activities of daily living, medical needs, and personal care, while prioritizing care in the least restrictive setting.
The program supports older adults and individuals with physical, intellectual, or developmental disabilities through person-centered planning that promotes dignity, independence, and quality of life.
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.
- • 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 co...
....Read more...
Type: Permanent Location: Roanoke, US-VA
Salary / Rate: Not Specified
Posted: 2025-12-27 07:29:43
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Create an outstanding customer experience through exceptional service.
Establish and maintain a safe and clean environment that encourages our customers to return.
Demonstrate the company's core values of respect, honesty, integrity, diversity, inclusion, and safety of others.Based in Northern California, Foods Co.
merged with The Kroger Company in 1998.
Today, we're proudly serving Foods Co.
customers in 20 stores throughout Northern California.
As part of the Kroger family of companies, we take pride in bringing diverse teams with a passion for food and people together with one common purpose: To Feed the Human Spirit.
With a history of innovation, we work tirelessly to create amazing experiences for our customers, communities AND each other, with food at the heart of it all.
Here, people matter.
That's why we strive to provide the ingredients you need to create your own recipe for success at work and in life.
We help feed your future by providing the value and care you need to grow.
If you're caring, purpose-driven and hungry to learn, your potential is unlimited.
Whether you're seeking a part-time position or a new career path, we've got a fresh opportunity for you.
Apply today to become part of our Foods Co.
family!
What you'll receive from us:
The Kroger Family of Companies offers comprehensive benefits to support your Associate Well-Being, including Physical, Emotional, Financial and more.
We'll help you thrive, with access to:
* A wide range of healthcare coverage, including affordable, comprehensive medical, dental, vision and prescription coverage, through company plans or collective bargaining agreement plans.
* Flexible scheduling in full- and part-time roles with paid time off, including holiday and sick pay based on eligibility and length of service.
* Emotional and financial support with free counseling through our Employee Assistance Program and free, confidential financial tools and coaching with Goldman Sachs Ayco.
* Valuable associate discounts on purchases, including food, travel, technology and so much more.
* Up to $21,000 in tuition reimbursement over your career, through our industry-leading Continuing Education program.
* Vast potential for growth, through an abundance of industry-leading training programs and diverse career pathways.
For more information about benefits and eligibility, please visit our Benefits Page ! Minimum Position Qualifications:
* Customer service experience
* Effective communication skills
* Knowledge of basic math (counting, addition, and subtraction)
Desired Previous Job Experience:
* Customer service experience
* Prior experience as a Bagger or Courtesy Clerk
Essential Job Functions:
• Cashier/Checker is responsible for being visible and actively greeting, engaging and assisting customers.
• Cashiers process customer transactions through the check lane quickly, accurately, and efficiently.
• Checkers understand the Poin...
....Read more...
Type: Permanent Location: San Francisco, US-CA
Salary / Rate: 21.36
Posted: 2025-12-27 07:29:42
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Description & Requirements
Maximus is seeking a Clinical Reviewer (Registered Nurse) to support the Tennessee (TN) Appeals area of the contract.
In this role, the RN Clinical Reviewer is responsible for reviewing clinical cases, applying nursing judgment and regulatory guidelines, and ensuring each case is accurately assessed and routed to the appropriate department or escalated as needed.
This position plays a critical role in maintaining compliance, supporting timely appeal resolutions, and ensuring high-quality, clinically sound decision-making.
About the Program:Tennessee Long-Term Services and Supports (TN LTSS) refers to a coordinated system of programs and services designed to assist individuals who have chronic illnesses, disabilities, or functional limitations and need ongoing support to live as independently and safely as possible.
TN LTSS includes a range of home- and community-based services (HCBS) and institutional care options that help individuals with activities of daily living, medical needs, and personal care, while prioritizing care in the least restrictive setting.
The program supports older adults and individuals with physical, intellectual, or developmental disabilities through person-centered planning that promotes dignity, independence, and quality of life.
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.
- • 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 co...
....Read more...
Type: Permanent Location: Richmond, US-VA
Salary / Rate: Not Specified
Posted: 2025-12-27 07:29:42
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Description & Requirements
Maximus is seeking a Clinical Reviewer (Registered Nurse) to support the Tennessee (TN) Appeals area of the contract.
In this role, the RN Clinical Reviewer is responsible for reviewing clinical cases, applying nursing judgment and regulatory guidelines, and ensuring each case is accurately assessed and routed to the appropriate department or escalated as needed.
This position plays a critical role in maintaining compliance, supporting timely appeal resolutions, and ensuring high-quality, clinically sound decision-making.
About the Program:Tennessee Long-Term Services and Supports (TN LTSS) refers to a coordinated system of programs and services designed to assist individuals who have chronic illnesses, disabilities, or functional limitations and need ongoing support to live as independently and safely as possible.
TN LTSS includes a range of home- and community-based services (HCBS) and institutional care options that help individuals with activities of daily living, medical needs, and personal care, while prioritizing care in the least restrictive setting.
The program supports older adults and individuals with physical, intellectual, or developmental disabilities through person-centered planning that promotes dignity, independence, and quality of life.
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.
- • 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 co...
....Read more...
Type: Permanent Location: Houston, US-TX
Salary / Rate: Not Specified
Posted: 2025-12-27 07:29:41
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Description & Requirements
Maximus is seeking a Clinical Reviewer (Registered Nurse) to support the Tennessee (TN) Appeals area of the contract.
In this role, the RN Clinical Reviewer is responsible for reviewing clinical cases, applying nursing judgment and regulatory guidelines, and ensuring each case is accurately assessed and routed to the appropriate department or escalated as needed.
This position plays a critical role in maintaining compliance, supporting timely appeal resolutions, and ensuring high-quality, clinically sound decision-making.
About the Program:Tennessee Long-Term Services and Supports (TN LTSS) refers to a coordinated system of programs and services designed to assist individuals who have chronic illnesses, disabilities, or functional limitations and need ongoing support to live as independently and safely as possible.
TN LTSS includes a range of home- and community-based services (HCBS) and institutional care options that help individuals with activities of daily living, medical needs, and personal care, while prioritizing care in the least restrictive setting.
The program supports older adults and individuals with physical, intellectual, or developmental disabilities through person-centered planning that promotes dignity, independence, and quality of life.
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.
- • 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 co...
....Read more...
Type: Permanent Location: Salt Lake City, US-UT
Salary / Rate: Not Specified
Posted: 2025-12-27 07:29:41
-
Description & Requirements
Maximus is seeking a Clinical Reviewer (Registered Nurse) to support the Tennessee (TN) Appeals area of the contract.
In this role, the RN Clinical Reviewer is responsible for reviewing clinical cases, applying nursing judgment and regulatory guidelines, and ensuring each case is accurately assessed and routed to the appropriate department or escalated as needed.
This position plays a critical role in maintaining compliance, supporting timely appeal resolutions, and ensuring high-quality, clinically sound decision-making.
About the Program:Tennessee Long-Term Services and Supports (TN LTSS) refers to a coordinated system of programs and services designed to assist individuals who have chronic illnesses, disabilities, or functional limitations and need ongoing support to live as independently and safely as possible.
TN LTSS includes a range of home- and community-based services (HCBS) and institutional care options that help individuals with activities of daily living, medical needs, and personal care, while prioritizing care in the least restrictive setting.
The program supports older adults and individuals with physical, intellectual, or developmental disabilities through person-centered planning that promotes dignity, independence, and quality of life.
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.
- • 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 co...
....Read more...
Type: Permanent Location: St. George, US-UT
Salary / Rate: Not Specified
Posted: 2025-12-27 07:29:40
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Description & Requirements
Maximus is seeking a Clinical Reviewer (Registered Nurse) to support the Tennessee (TN) Appeals area of the contract.
In this role, the RN Clinical Reviewer is responsible for reviewing clinical cases, applying nursing judgment and regulatory guidelines, and ensuring each case is accurately assessed and routed to the appropriate department or escalated as needed.
This position plays a critical role in maintaining compliance, supporting timely appeal resolutions, and ensuring high-quality, clinically sound decision-making.
About the Program:Tennessee Long-Term Services and Supports (TN LTSS) refers to a coordinated system of programs and services designed to assist individuals who have chronic illnesses, disabilities, or functional limitations and need ongoing support to live as independently and safely as possible.
TN LTSS includes a range of home- and community-based services (HCBS) and institutional care options that help individuals with activities of daily living, medical needs, and personal care, while prioritizing care in the least restrictive setting.
The program supports older adults and individuals with physical, intellectual, or developmental disabilities through person-centered planning that promotes dignity, independence, and quality of life.
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.
- • 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 co...
....Read more...
Type: Permanent Location: San Antonio, US-TX
Salary / Rate: Not Specified
Posted: 2025-12-27 07:29:40
-
Description & Requirements
Maximus is seeking a Clinical Reviewer (Registered Nurse) to support the Tennessee (TN) Appeals area of the contract.
In this role, the RN Clinical Reviewer is responsible for reviewing clinical cases, applying nursing judgment and regulatory guidelines, and ensuring each case is accurately assessed and routed to the appropriate department or escalated as needed.
This position plays a critical role in maintaining compliance, supporting timely appeal resolutions, and ensuring high-quality, clinically sound decision-making.
About the Program:Tennessee Long-Term Services and Supports (TN LTSS) refers to a coordinated system of programs and services designed to assist individuals who have chronic illnesses, disabilities, or functional limitations and need ongoing support to live as independently and safely as possible.
TN LTSS includes a range of home- and community-based services (HCBS) and institutional care options that help individuals with activities of daily living, medical needs, and personal care, while prioritizing care in the least restrictive setting.
The program supports older adults and individuals with physical, intellectual, or developmental disabilities through person-centered planning that promotes dignity, independence, and quality of life.
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.
- • 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 co...
....Read more...
Type: Permanent Location: Lubbock, US-TX
Salary / Rate: Not Specified
Posted: 2025-12-27 07:29:39
-
Description & Requirements
Maximus is seeking a Clinical Reviewer (Registered Nurse) to support the Tennessee (TN) Appeals area of the contract.
In this role, the RN Clinical Reviewer is responsible for reviewing clinical cases, applying nursing judgment and regulatory guidelines, and ensuring each case is accurately assessed and routed to the appropriate department or escalated as needed.
This position plays a critical role in maintaining compliance, supporting timely appeal resolutions, and ensuring high-quality, clinically sound decision-making.
About the Program:Tennessee Long-Term Services and Supports (TN LTSS) refers to a coordinated system of programs and services designed to assist individuals who have chronic illnesses, disabilities, or functional limitations and need ongoing support to live as independently and safely as possible.
TN LTSS includes a range of home- and community-based services (HCBS) and institutional care options that help individuals with activities of daily living, medical needs, and personal care, while prioritizing care in the least restrictive setting.
The program supports older adults and individuals with physical, intellectual, or developmental disabilities through person-centered planning that promotes dignity, independence, and quality of life.
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.
- • 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 co...
....Read more...
Type: Permanent Location: Dallas, US-TX
Salary / Rate: Not Specified
Posted: 2025-12-27 07:29:38
-
Description & Requirements
Maximus is seeking a Clinical Reviewer (Registered Nurse) to support the Tennessee (TN) Appeals area of the contract.
In this role, the RN Clinical Reviewer is responsible for reviewing clinical cases, applying nursing judgment and regulatory guidelines, and ensuring each case is accurately assessed and routed to the appropriate department or escalated as needed.
This position plays a critical role in maintaining compliance, supporting timely appeal resolutions, and ensuring high-quality, clinically sound decision-making.
About the Program:Tennessee Long-Term Services and Supports (TN LTSS) refers to a coordinated system of programs and services designed to assist individuals who have chronic illnesses, disabilities, or functional limitations and need ongoing support to live as independently and safely as possible.
TN LTSS includes a range of home- and community-based services (HCBS) and institutional care options that help individuals with activities of daily living, medical needs, and personal care, while prioritizing care in the least restrictive setting.
The program supports older adults and individuals with physical, intellectual, or developmental disabilities through person-centered planning that promotes dignity, independence, and quality of life.
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.
- • 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 co...
....Read more...
Type: Permanent Location: Sioux Falls, US-SD
Salary / Rate: Not Specified
Posted: 2025-12-27 07:29:38
-
Description & Requirements
Maximus is seeking a Clinical Reviewer (Registered Nurse) to support the Tennessee (TN) Appeals area of the contract.
In this role, the RN Clinical Reviewer is responsible for reviewing clinical cases, applying nursing judgment and regulatory guidelines, and ensuring each case is accurately assessed and routed to the appropriate department or escalated as needed.
This position plays a critical role in maintaining compliance, supporting timely appeal resolutions, and ensuring high-quality, clinically sound decision-making.
About the Program:Tennessee Long-Term Services and Supports (TN LTSS) refers to a coordinated system of programs and services designed to assist individuals who have chronic illnesses, disabilities, or functional limitations and need ongoing support to live as independently and safely as possible.
TN LTSS includes a range of home- and community-based services (HCBS) and institutional care options that help individuals with activities of daily living, medical needs, and personal care, while prioritizing care in the least restrictive setting.
The program supports older adults and individuals with physical, intellectual, or developmental disabilities through person-centered planning that promotes dignity, independence, and quality of life.
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.
- • 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 co...
....Read more...
Type: Permanent Location: Rapid City, US-SD
Salary / Rate: Not Specified
Posted: 2025-12-27 07:29:37
-
Description & Requirements
Maximus is seeking a Clinical Reviewer (Registered Nurse) to support the Tennessee (TN) Appeals area of the contract.
In this role, the RN Clinical Reviewer is responsible for reviewing clinical cases, applying nursing judgment and regulatory guidelines, and ensuring each case is accurately assessed and routed to the appropriate department or escalated as needed.
This position plays a critical role in maintaining compliance, supporting timely appeal resolutions, and ensuring high-quality, clinically sound decision-making.
About the Program:Tennessee Long-Term Services and Supports (TN LTSS) refers to a coordinated system of programs and services designed to assist individuals who have chronic illnesses, disabilities, or functional limitations and need ongoing support to live as independently and safely as possible.
TN LTSS includes a range of home- and community-based services (HCBS) and institutional care options that help individuals with activities of daily living, medical needs, and personal care, while prioritizing care in the least restrictive setting.
The program supports older adults and individuals with physical, intellectual, or developmental disabilities through person-centered planning that promotes dignity, independence, and quality of life.
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.
- • 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 co...
....Read more...
Type: Permanent Location: Nashville, US-TN
Salary / Rate: Not Specified
Posted: 2025-12-27 07:29:36
-
Description & Requirements
Maximus is seeking a Clinical Reviewer (Registered Nurse) to support the Tennessee (TN) Appeals area of the contract.
In this role, the RN Clinical Reviewer is responsible for reviewing clinical cases, applying nursing judgment and regulatory guidelines, and ensuring each case is accurately assessed and routed to the appropriate department or escalated as needed.
This position plays a critical role in maintaining compliance, supporting timely appeal resolutions, and ensuring high-quality, clinically sound decision-making.
About the Program:Tennessee Long-Term Services and Supports (TN LTSS) refers to a coordinated system of programs and services designed to assist individuals who have chronic illnesses, disabilities, or functional limitations and need ongoing support to live as independently and safely as possible.
TN LTSS includes a range of home- and community-based services (HCBS) and institutional care options that help individuals with activities of daily living, medical needs, and personal care, while prioritizing care in the least restrictive setting.
The program supports older adults and individuals with physical, intellectual, or developmental disabilities through person-centered planning that promotes dignity, independence, and quality of life.
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.
- • 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 co...
....Read more...
Type: Permanent Location: Memphis, US-TN
Salary / Rate: Not Specified
Posted: 2025-12-27 07:29:35
-
Create an outstanding customer experience through exceptional service.
Establish and maintain a safe and clean environment that encourages our customers to return.
Demonstrate the company's core values of respect, honesty, integrity, diversity, inclusion, and safety of others.Based in California, Food 4 Less merged with The Kroger Company in 1998.
Today, we're proudly serving Food 4 Less customers in over 100 stores throughout California and the Midwest.
As part of the Kroger family of companies, we take pride in bringing diverse teams with a passion for food and people together with one common purpose: To Feed the Human Spirit.
With a history of innovation, we work tirelessly to create amazing experiences for our customers, communities AND each other, with food at the heart of it all.
Here, people matter.
That's why we strive to provide the ingredients you need to create your own recipe for success at work and in life.
We help feed your future by providing the value and care you need to grow.
If you're caring, purpose-driven and hungry to learn, your potential is unlimited.
Whether you're seeking a part-time position or a new career path, we've got a fresh opportunity for you.
Apply today to become part of our Food 4 Less family!
Qualified applications with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.
If you are in need of reasonable accommodation to complete a job application or to otherwise participate in the application or pre-hiring process, please call 844-849-7136 or contact the location's management.
What you'll receive from us:
The Kroger Family of Companies offers comprehensive benefits to support your Associate Well-Being, including Physical, Emotional, Financial and more.
We'll help you thrive, with access to:
* A wide range of healthcare coverage, including affordable, comprehensive medical, dental, vision and prescription coverage, through company plans or collective bargaining agreement plans.
* Flexible scheduling in full- and part-time roles with paid time off, including holiday and sick pay based on eligibility and length of service.
* Emotional and financial support with free counseling through our Employee Assistance Program and free, confidential financial tools and coaching with Goldman Sachs Ayco.
* Valuable associate discounts on purchases, including food, travel, technology and so much more.
* Up to $21,000 in tuition reimbursement over your career, through our industry-leading Continuing Education program.
* Vast potential for growth, through an abundance of industry-leading training programs and diverse career pathways.
For more information about benefits and eligibility, please visit our Benefits Page ! Minimum Position Qualifications:
* Customer Service skills
* Effective communication skills
Desired Previous Job Experience
* Reta...
....Read more...
Type: Permanent Location: Compton, US-CA
Salary / Rate: 17.175
Posted: 2025-12-27 07:29:35
-
Description & Requirements
Maximus is seeking a Clinical Reviewer (Registered Nurse) to support the Tennessee (TN) Appeals area of the contract.
In this role, the RN Clinical Reviewer is responsible for reviewing clinical cases, applying nursing judgment and regulatory guidelines, and ensuring each case is accurately assessed and routed to the appropriate department or escalated as needed.
This position plays a critical role in maintaining compliance, supporting timely appeal resolutions, and ensuring high-quality, clinically sound decision-making.
About the Program:Tennessee Long-Term Services and Supports (TN LTSS) refers to a coordinated system of programs and services designed to assist individuals who have chronic illnesses, disabilities, or functional limitations and need ongoing support to live as independently and safely as possible.
TN LTSS includes a range of home- and community-based services (HCBS) and institutional care options that help individuals with activities of daily living, medical needs, and personal care, while prioritizing care in the least restrictive setting.
The program supports older adults and individuals with physical, intellectual, or developmental disabilities through person-centered planning that promotes dignity, independence, and quality of life.
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.
- • 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 co...
....Read more...
Type: Permanent Location: Philadelphia, US-PA
Salary / Rate: Not Specified
Posted: 2025-12-27 07:29:34
-
Description & Requirements
Maximus is seeking a Clinical Reviewer (Registered Nurse) to support the Tennessee (TN) Appeals area of the contract.
In this role, the RN Clinical Reviewer is responsible for reviewing clinical cases, applying nursing judgment and regulatory guidelines, and ensuring each case is accurately assessed and routed to the appropriate department or escalated as needed.
This position plays a critical role in maintaining compliance, supporting timely appeal resolutions, and ensuring high-quality, clinically sound decision-making.
About the Program:Tennessee Long-Term Services and Supports (TN LTSS) refers to a coordinated system of programs and services designed to assist individuals who have chronic illnesses, disabilities, or functional limitations and need ongoing support to live as independently and safely as possible.
TN LTSS includes a range of home- and community-based services (HCBS) and institutional care options that help individuals with activities of daily living, medical needs, and personal care, while prioritizing care in the least restrictive setting.
The program supports older adults and individuals with physical, intellectual, or developmental disabilities through person-centered planning that promotes dignity, independence, and quality of life.
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.
- • 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 co...
....Read more...
Type: Permanent Location: Columbia, US-SC
Salary / Rate: Not Specified
Posted: 2025-12-27 07:29:34
-
Description & Requirements
Maximus is seeking a Clinical Reviewer (Registered Nurse) to support the Tennessee (TN) Appeals area of the contract.
In this role, the RN Clinical Reviewer is responsible for reviewing clinical cases, applying nursing judgment and regulatory guidelines, and ensuring each case is accurately assessed and routed to the appropriate department or escalated as needed.
This position plays a critical role in maintaining compliance, supporting timely appeal resolutions, and ensuring high-quality, clinically sound decision-making.
About the Program:Tennessee Long-Term Services and Supports (TN LTSS) refers to a coordinated system of programs and services designed to assist individuals who have chronic illnesses, disabilities, or functional limitations and need ongoing support to live as independently and safely as possible.
TN LTSS includes a range of home- and community-based services (HCBS) and institutional care options that help individuals with activities of daily living, medical needs, and personal care, while prioritizing care in the least restrictive setting.
The program supports older adults and individuals with physical, intellectual, or developmental disabilities through person-centered planning that promotes dignity, independence, and quality of life.
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.
- • 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 co...
....Read more...
Type: Permanent Location: Eugene, US-OR
Salary / Rate: Not Specified
Posted: 2025-12-27 07:29:33
-
Description & Requirements
Maximus is seeking a Clinical Reviewer (Registered Nurse) to support the Tennessee (TN) Appeals area of the contract.
In this role, the RN Clinical Reviewer is responsible for reviewing clinical cases, applying nursing judgment and regulatory guidelines, and ensuring each case is accurately assessed and routed to the appropriate department or escalated as needed.
This position plays a critical role in maintaining compliance, supporting timely appeal resolutions, and ensuring high-quality, clinically sound decision-making.
About the Program:Tennessee Long-Term Services and Supports (TN LTSS) refers to a coordinated system of programs and services designed to assist individuals who have chronic illnesses, disabilities, or functional limitations and need ongoing support to live as independently and safely as possible.
TN LTSS includes a range of home- and community-based services (HCBS) and institutional care options that help individuals with activities of daily living, medical needs, and personal care, while prioritizing care in the least restrictive setting.
The program supports older adults and individuals with physical, intellectual, or developmental disabilities through person-centered planning that promotes dignity, independence, and quality of life.
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.
- • 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 co...
....Read more...
Type: Permanent Location: Charleston, US-SC
Salary / Rate: Not Specified
Posted: 2025-12-27 07:29:32
-
Description & Requirements
Maximus is seeking a Clinical Reviewer (Registered Nurse) to support the Tennessee (TN) Appeals area of the contract.
In this role, the RN Clinical Reviewer is responsible for reviewing clinical cases, applying nursing judgment and regulatory guidelines, and ensuring each case is accurately assessed and routed to the appropriate department or escalated as needed.
This position plays a critical role in maintaining compliance, supporting timely appeal resolutions, and ensuring high-quality, clinically sound decision-making.
About the Program:Tennessee Long-Term Services and Supports (TN LTSS) refers to a coordinated system of programs and services designed to assist individuals who have chronic illnesses, disabilities, or functional limitations and need ongoing support to live as independently and safely as possible.
TN LTSS includes a range of home- and community-based services (HCBS) and institutional care options that help individuals with activities of daily living, medical needs, and personal care, while prioritizing care in the least restrictive setting.
The program supports older adults and individuals with physical, intellectual, or developmental disabilities through person-centered planning that promotes dignity, independence, and quality of life.
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.
- • 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 co...
....Read more...
Type: Permanent Location: Newport, US-RI
Salary / Rate: Not Specified
Posted: 2025-12-27 07:29:31
-
Description & Requirements
Maximus is seeking a Clinical Reviewer (Registered Nurse) to support the Tennessee (TN) Appeals area of the contract.
In this role, the RN Clinical Reviewer is responsible for reviewing clinical cases, applying nursing judgment and regulatory guidelines, and ensuring each case is accurately assessed and routed to the appropriate department or escalated as needed.
This position plays a critical role in maintaining compliance, supporting timely appeal resolutions, and ensuring high-quality, clinically sound decision-making.
About the Program:Tennessee Long-Term Services and Supports (TN LTSS) refers to a coordinated system of programs and services designed to assist individuals who have chronic illnesses, disabilities, or functional limitations and need ongoing support to live as independently and safely as possible.
TN LTSS includes a range of home- and community-based services (HCBS) and institutional care options that help individuals with activities of daily living, medical needs, and personal care, while prioritizing care in the least restrictive setting.
The program supports older adults and individuals with physical, intellectual, or developmental disabilities through person-centered planning that promotes dignity, independence, and quality of life.
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.
- • 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 co...
....Read more...
Type: Permanent Location: Providence, US-RI
Salary / Rate: Not Specified
Posted: 2025-12-27 07:29:31
-
Description & Requirements
Maximus is seeking a Clinical Reviewer (Registered Nurse) to support the Tennessee (TN) Appeals area of the contract.
In this role, the RN Clinical Reviewer is responsible for reviewing clinical cases, applying nursing judgment and regulatory guidelines, and ensuring each case is accurately assessed and routed to the appropriate department or escalated as needed.
This position plays a critical role in maintaining compliance, supporting timely appeal resolutions, and ensuring high-quality, clinically sound decision-making.
About the Program:Tennessee Long-Term Services and Supports (TN LTSS) refers to a coordinated system of programs and services designed to assist individuals who have chronic illnesses, disabilities, or functional limitations and need ongoing support to live as independently and safely as possible.
TN LTSS includes a range of home- and community-based services (HCBS) and institutional care options that help individuals with activities of daily living, medical needs, and personal care, while prioritizing care in the least restrictive setting.
The program supports older adults and individuals with physical, intellectual, or developmental disabilities through person-centered planning that promotes dignity, independence, and quality of life.
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.
- • 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 co...
....Read more...
Type: Permanent Location: Portland, US-OR
Salary / Rate: Not Specified
Posted: 2025-12-27 07:29:30
-
Description & Requirements
Maximus is seeking a Clinical Reviewer (Registered Nurse) to support the Tennessee (TN) Appeals area of the contract.
In this role, the RN Clinical Reviewer is responsible for reviewing clinical cases, applying nursing judgment and regulatory guidelines, and ensuring each case is accurately assessed and routed to the appropriate department or escalated as needed.
This position plays a critical role in maintaining compliance, supporting timely appeal resolutions, and ensuring high-quality, clinically sound decision-making.
About the Program:Tennessee Long-Term Services and Supports (TN LTSS) refers to a coordinated system of programs and services designed to assist individuals who have chronic illnesses, disabilities, or functional limitations and need ongoing support to live as independently and safely as possible.
TN LTSS includes a range of home- and community-based services (HCBS) and institutional care options that help individuals with activities of daily living, medical needs, and personal care, while prioritizing care in the least restrictive setting.
The program supports older adults and individuals with physical, intellectual, or developmental disabilities through person-centered planning that promotes dignity, independence, and quality of life.
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.
- • 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 co...
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Type: Permanent Location: Pittsburgh, US-PA
Salary / Rate: Not Specified
Posted: 2025-12-27 07:29:30
