Clinical Review Lead Coordinator, LPN/RN

Join our California Independent Medical Review (CA IMR) team as a Lead Coordinator - Clinical Review, LPN/RN, supporting the review of workers’ compensation medical cases.

In this fully remote, non-bedside role, you’ll use your nursing experience to review and interpret medical records, identify key clinical information, and prepare clear, accurate summaries for expert review.

At Maximus, we are committed to cultivating a positive and inclusive work environment, and we are pleased to offer the following:

Work/Life Balance Support - Flexibility tailored to your needs!

Comprehensive Insurance Coverage - Medical, Dental, Vision, Life insurance, and enjoy 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.

Essential Duties and Responsibilities:
-Review medical documentation to ensure sufficiency to allow for completion of clinical summary template

- Complete clinical summary template
- Review requested treatments to ensure accurate entry
- Review expert specialty designation for accuracy; escalate case for any questions/concerns outside normal case processing

- Perform other duties as assigned



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*Minimum Requirements:
- High School Degree and 2+ years clinical experience required; Associate's Degree preferred or equivalent combination of education or experience
- Current Licensed Practical Nurse (LPN) OR Current Registered Nurse (RN) licenses valid in the state of practice is required
- Minimum 1 year of clinical experience required

- Experience reviewing and interpreting clinical documentation, including physician and progress notes.
- Strong written communication skills with the ability to produce clear, grammatically accurate summaries.
- Proficiency with Microsoft Word, Excel, PowerPoint, and Outlook and ability to learn multiple computer applications.

Preferred Skills

- Experience with clinical review, utilization management, or appeals.

- Knowledge of healthcare regulations, guidelines, or coverage issues.

Maximus is an equal opportunity employer.

We evaluate qualified applicants wit...