Clinical Reviewer (Remote)

Company: Maximus
Location: Waipahu
Posted on: November 25, 2022

Job Description:

Maximus is currently hiring for a CLINICAL REVIEWER! This role reviews clinical documentation and requests submitted by individuals and/or providers to determine appropriate level of care and/or prior authorization.
This position is full time and fully remote. The work schedule is monday-firday.
EDUCATION AND EXPERIENCE REQUIREMENTS
MINIMUM REQUIREMENTS:
Bachelor's Degree or equivalent required
Active LPN or RN licensure

2+ years related experience with Intellectual and Developmental Disabilities
or psychiatric nursing

Effective communication skills and ability to follow directions
Ability to interact courteously and effectively with a variety of people
Ability to handle pressure and perform multiple tasks
Must be able to (at minimum) type 35 WPM
Proficiency in Microsoft Office applications as Excel, Power Point, and Word
HOME OFFICE REQUIREMENTS:
Reliable high-speed internet service with a minimum download speed of 25 Mbps and 5 Mbps upload speed (you can test this by going to www.speedtest.net)

Private work area with adequate power source

MAXIMUS INTRODUCTION
Since 1975, Maximus has operated under its founding mission of Helping Government Serve the People, enabling citizens around the globe to successfully engage with their governments at all levels and across a variety of health and human services programs. Maximus delivers innovative business process management and technology solutions that contribute to improved outcomes for citizens and higher levels of productivity, accuracy, accountability and efficiency of government-sponsored programs. With more than 30,000 employees worldwide, Maximus is a proud partner to government agencies in the United States, Australia, Canada, Saudi Arabia, Singapore and the United Kingdom. For more information, visit https://www.maximus.com
As a large employer and Federal contractor, Maximus is subject to various vaccine mandates across our lines of business. Maximus is committed to complying with any applicable vaccine mandates. The specific vaccine requirements for this position will be outlined throughout the selection process. Individuals who believe they may qualify for a medical or religious accommodation will have the opportunity to apply for an accommodation following an offer of employment.
EEO STATEMENT
Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential and bring a resiliency and dependability that greatly enhances our workforce. We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a difference for our country. We are proud of our connections to organizations dedicated to serving veterans and their families. If you are transitioning from military to civilian life, have prior service, are a retired veteran or a member of the National Guard or Reserves, or a spouse of an active military service member, we have challenging and rewarding career opportunities available for you. A committed and diverse workforce is our most important resource. Maximus is an Affirmative Action/Equal Opportunity Employer. Maximus provides equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status or disabled status.
PAY TRANSPARENCY
Maximus compensation is based on various factors including but not limited to 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. Compensation shall be commensurate with job duties and relevant work experience. An applicant's salary history will not be used in determining compensation.

Keywords: Maximus, Honolulu , Clinical Reviewer (Remote), Healthcare , Waipahu, Hawaii