Clinical Reviewer, LPN (Remote)

We have contracted with the State of Illinois Department of Healthcare and Family Services (HFS) to manage the assessment process for Preadmission Screening and Resident Review (PASRR) Level I screens and completing Level II Serious Mental Illness (SMI) evaluations for individuals applying to, or residing in, Medicaid-certified nursing facilities. Other services include Follow Up Visits, admissions support for Specialized Mental Health Rehabilitation Facilities (SMHRF) and Supported Living Programs (SLP) settings and Colbert Dementia Review. Continue reading below for more details and links to support resources for each of these services.

Maximus is hiring a Clinical Reviewer, LPN to join our team! In this role will you’ll review Level I PASRR screenings, evaluate the completed screens, and determine whether an individual requires a more comprehensive PASRR evaluation. This position plays a key role in reviewing assessments for our Illinois and South Dakota projects. An active LPN license valid in Illinois or South Dakota is required; compact licenses are accepted.

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 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. Performs other related duties as assigned.