Clinical Reviewer Remote

Maximus is hiring a Clinical Reviewer to support the Illinois SALT program. The Clinical Reviewer is responsible for evaluating assessments and making determinations regarding individuals' needs for additional supports and services. This role includes conducting quality control reviews of field assessors' work to ensure accuracy and compliance.

** Candidates must be available to transition to one of the following work schedules after successfully completing 100 days of training.

Monday to Friday, 8:00 AM – 5:00 PM CST

Thursday to Sunday, 8:00 AM - 6:30 PM CST

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.

Continues to expand assessment services in the state.

• 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 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
• 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

• 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

• Preferred knowledge may include 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

• Education and licensure requirements are based on program contract requirements and are outlined in job posting
• High School Degree or equivalent required
• Minimum 1 year of clinical experience required
• Master’s Degree in Social Work, Mental Health or related degree program
• 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

• Demonstrates outstanding interpersonal and verbal communication skills
• Demonstrates strong proficiency in written communication, producing concise and impactful documentation
• IM+CANS certification or willingness to obtain IM+CANS certification
• Strong computer skills
• Knowledgeable about PASRR

• Maximus provides company-issued computer equipment
• 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