Clinical Reviewer, LPN (Remote)

Description & Requirements

Maximus is hiring a Clinical Reviewer, LPN to join our team! In this role will you'll review Level I PASRR screenings, evaluate the completed screens, and determine whether an individual requires a more comprehensive PASRR evaluation.

This position plays a key role in reviewing assessments for our Illinois and South Dakota projects.

An active LPN license valid in Illinois or South Dakota is required; compact licenses are accepted.

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.

Continue reading below for more details and links to support resources for each of these services.

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.

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.

Minimum Re...