Maximus

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 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.

Required Skills/Abilities:
- 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 
- 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

- 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
- LPN, RN, LCSW, or related licensure preferred and may be required based on contract requirements

Maximus compensation is based on various factors including but not limited to job location, 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 ranges may differ based on contract value but will be commensurate with job duties and relevant work experience. An applicant's salary history will not be used in determining compensation. Maximus will comply with regulatory minimum wage rates and exempt salary thresholds in all instances.