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LPN Clinical Reviewer (Remote Opportunity)

Work from home Full-time role Hiring

Join Maximus as a Licensed Practical Nurse (LPN) Clinical Reviewer, supporting the Connecticut PASRR Program. In this role, you will conduct initial screenings to determine the existence of a PASRR condition and the appropriate level of care for nursing facility services. Enjoy the flexibility of a fully remote work environment, with a schedule of Monday to Friday, 7:30 am to 4:00 pm Central Time Zone.

About the Program: We partner with the Department of Social Services to perform Preadmission Screening and Resident Review (PASRR) for individuals applying to or residing in Medicaid-certified nursing homes. The primary goal of this federally mandated assessment is to determine whether the nursing home is the appropriate placement for individuals with mental illness, intellectual disabilities, or developmental disabilities.

Why Choose Maximus?

  • Work-Life Balance Support: Flexibility tailored to your needs
  • Competitive Compensation: Bonuses based on performance included
  • Comprehensive Insurance Coverage: Choose from various plans, including Medical, Dental, Vision, Prescription, and partially funded HSA
  • 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
  • Licensures and Certifications: Maximus assumes the expenses associated with renewing licenses and certifications for its employees

Essential Duties and Responsibilities:

  • 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
  • Identify the need for additional clinical documentation or consultation
  • Complete documentation of activities within contract systems
  • Communicate with providers, individuals, and their designees, or state workers as required
  • Perform other related duties as assigned

Required Skills/Abilities:

  • Preferred knowledge of community support programs, long-term care assessment, and level of care in medical, behavioral health, or related programs
  • Knowledge and understanding of medical and/or behavioral health diagnoses and prescribed medications
  • Ability to collect data, define problems, establish facts, and draw valid conclusions
  • Excellent written and verbal communication skills
  • Excellent interpersonal and customer service skills
  • Proficient in Microsoft Office Suite
  • Excellent organizational skills and attention to detail
  • Ability to work in a fast-paced environment
  • Ability to work independently and meet timelines

Minimum Requirements:

  • High School Degree or equivalent required
  • Minimum 1 year of clinical experience required
  • LPN, RN, LCSW, or related licensure preferred and may be required based on contract requirements
  • Active, unrestricted LPN license in Connecticut or a compact license required
  • 3 years of mental health experience required
  • 3 years of long-term care experience required

Preferred Skills:

  • PASRR experience
  • Time management

Hourly Base Pay Range: $21.75 - $25.00

Maximus is an Affirmative Action/Equal Opportunity Employer. We provide 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.

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