Clinical Reviewer-LPN (Remote
Description & Requirements Maximus is seeking a Clinical Reviewer (LPN) supporting the Colorado HMA (Health Maintenance Activities) Review Program. The reviewer must participate in all required trainings and meetings, in addition to other tasks as required by their supervisor.
- Position is contingent upon contract award
- Work Schedule: This position is scheduled Monday through Friday from 8:00 a.m. Mountain Time with some weekend coverage required based on business 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.
- Professional Development Opportunities-Participate in training programs, workshops, and conferences.
- 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.
- Complete documentation of activities within contract systems.
- Current Licensed Practical Nurse (LPN) license valid in the state of practice is required
- Associate degree in Nursing
- An active LPN license in the state of Colorado or a compact license is required
- Minimum 2 years of experience working with people with complex disabilities, including pediatric and geriatric populations
- Familiarity with Home and Community Based Services waivers (HCBS)
- Proficiency in Microsoft Office applications
Prior experience conducting document-based reviews
- Previous experience working remotely
- Prior experience conducting document-based reviews
Home Office Requirements:
- Maximus provides company-issued computer equipment
- Private and secure workspace
We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics. 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. 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. Compensation ranges may differ based on contract value but will be commensurate with job duties and relevant work experience. Maximus will comply with regulatory minimum wage rates and exempt salary thresholds in all instances. Maximus provides reasonable accommodations to individuals requiring assistance during any phase of the employment process due to a disability, medical condition, or physical or mental impairment. If you require assistance at any stage of the employment process-including accessing job postings, completing assessments, or participating in interviews,-please contact People Operations at View email address on click.appcast.io. Apply tot his job Apply To this Job