Clinical Assessor, Registered Nurse - (Hybrid Remote - Worcester, MA)

Essential Duties and Responsibilities:

- Responsible for completing medical and/or behavioral health assessments within contract requirements

- Conducts on-site, video call and/or telephonic assessments to determine an individual's needs for services and supports, eligibility, level of care or related outcome

- Perform all job duties in compliance with Person First standards, HIPAA guidelines, and company confidentiality policies and procedures.

- Travel may be required based on program contract requirements

- Performs other related duties as assigned.

-Conduct assessments using standardized tools (UCA, TTT) to identify medical, functional, and social needs
-Develop and manage service plans for complex or high-acuity members, coordinating with healthcare providers, case managers, and community resources
-Evaluate eligibility for recommended referrals to other professionals or agencies
-Maintain compliance with state and federal regulations, Medicaid/LTSS program guidelines, and electronic health record systems
-Collaborate with care teams to revise care plans as needs change, ensuring alignment with member goals
-Provide education to members, families, and caregivers on available services and options
-Document assessments and care activities accurately to support billing, compliance, and quality reporting
-Advocate for members to help them remain in preferred living environments and maintain independence

Minimum Requirements

- Current Registered Nurse (RN) license valid in the state of practice is required

- High School Degree or equivalent required

- Minimum 2 years of clinical experience required

- An active, unencumbered Registered Nurse (RN) license in the state of Massachusetts.

- Minimum of two (2) years of relevant post-graduate clinical experience as a Registered Nurse.

- Experience working with vulnerable populations, including individuals with behavioral health needs, intellectual and developmental disabilities (I/DD), and those requiring long-term services and supports (LTSS).

- Experience conducting clinical or functional assessments in home or community-based settings, such as behavioral health evaluations, level of care determinations, or utilization reviews.

- Knowledge of community-based services, care coordination, and person-centered care planning.

- Familiarity with MassHealth programs, LTSS, and Home and Community-Based Services (HCBS) waiver programs.

- Proficiency in Microsoft Office applications.

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Experience documenting assessments in electronic systems.

Home Office Requirements

- Maximus provides company-issued computer equipment

- Reliable high-speed internet service

- Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity

- Minimum 5 Mpbs 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 i...