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

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.

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