Clinical Reviewer

🔥 1 minute ago

🌽 Illinois – Remote

🌽 Illinois – Remote

💵 $25 - $30 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🔍🏥 Medical Reviewer

🚫👨‍🎓 No degree required

👻 Ghost score 0%

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Maximus

WebsiteLinkedInAll Job Openings

10,000+ employees

🏛️ Government

🏥 Healthcare

💼 Consulting

💰 $7.9M Post-IPO Equity - Maximus on 2010-12

Government • Healthcare • Consulting

Maximus is a public-sector services firm that partners with government agencies to modernize and operate programs across health, human services, defense, national security, and civilian agencies. The company combines technology (AI, analytics, cloud, cybersecurity), omnichannel contact center and eligibility/enrollment systems, clinical and Medicaid enterprise services, and consulting and program-delivery capabilities to improve citizen experience and program outcomes. Backed by decades of government experience and scale, Maximus supports federal, state, and local clients with human-centered operational support and end-to-end digital modernization.

📋 Description

• Evaluate assessments and make determinations regarding individuals' needs for additional supports and services • Conduct quality control reviews of field assessors' work to ensure accuracy and compliance • Review routine service requests, including admissions, discharges, and continued stays, using established clinical criteria, state and federal policy, and contract requirements • Escalate complex or non-standard cases outside defined protocols • Issue approvals, denials, or recommendations based on contract requirements and standardized decision frameworks • Identify needs for additional clinical documentation or consultation and seek guidance from senior staff • Complete timely and accurate documentation of review activities in contract systems • Communicate with providers, individuals and their designees, or state workers • Write substantiated clinical determination reports by synthesizing assessment findings, interview data, and supporting documentation, including summaries of findings • Support the Illinois SALT program and assessment processes for PASRR Level I screens and Level II SMI evaluations

🎯 Requirements

• High school diploma or GED required and 2+ years of relevant professional experience required, or equivalent combination of education and experience • Master’s degree in counseling, social work, psychology, closely related field OR active, unrestricted RN license • 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 • Outstanding interpersonal and verbal communication skills • Strong proficiency in written communication, producing concise and impactful documentation • IM+CANS certification or willingness to obtain IM+CANS certification • Strong computer skills • Knowledge of PASRR • 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

🏖️ Benefits

• Work/Life Balance Support and flexibility • Performance-based bonuses • Medical, Dental, Vision, Prescription insurance • Partially funded HSA • Life insurance benefits • Auto, Home, Renter's, and Pet insurance discounts • 401K Retirement Savings plan and Company Matching • Paid time off, holidays, and extended sick leave • Short- and Long-Term Disability coverage • Employee Assistance Program (EAP) for physical, emotional, and financial wellness • Recognition Platform • Tuition Reimbursement • Employee perks and discounts • Maximus Wellness Program and Resources • Professional Development Opportunities, including training programs, workshops, and conferences • Company-issued computer equipment