Clinical Review Lead Coordinator - VA SIS Job at Maximus
Job Introduction:
This is a hybrid remote opportunity with approximately 30% travel required to complete face to face assessments; must live in the state of Virginia. The remaining 70% of time will be worked from home.
Job Description Summary:
Home Office Requirements:
#ClinicalServices #RichmondVA #VirginiaHeathcareCoordinator #ClinicalManager #HealthcareCoordinator #PatientCareCoordinator #OperationsManager #QualityImprovement #ClinicalReviewer #CaseManager #CareManager #LeadCoordinator #HealthCoordinator #AssessmentReviewer #ClinicalAssessmentReviewer #IDDAssessor #SISAssessor #OperationsCoordinator #LicenedSocialWorker #HyridRemoteVirginia #Hybrid
MAXIMUS Introduction: Since 1975, Maximus has operated under its founding mission of Helping Government Serve the People, enabling citizens around the globe to successfully engage with their governments at all levels and across a variety of health and human services programs. Maximus delivers innovative business process management and technology solutions that contribute to improved outcomes for citizens and higher levels of productivity, accuracy, accountability and efficiency of government-sponsored programs. With more than 30,000 employees worldwide, Maximus is a proud partner to government agencies in the United States, Australia, Canada, Saudi Arabia, Singapore and the United Kingdom. For more information, visit https://www.maximus.com. EEO Statement: EEO Statement: Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce. We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a difference for our country. We’re proud of our connections to organizations dedicated to serving veterans and their families. If you are transitioning from military to civilian life, have prior service, are a retired veteran or a member of the National Guard or Reserves, or a spouse of an active military service member, we have challenging and rewarding career opportunities available for you. A committed and diverse workforce is our most important resource. Maximus is an Affirmative Action/Equal Opportunity Employer. Maximus provides 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. Pay Transparency: 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. Posted Max: USD $29.00/Hr. Posted Min: USD $17.26/Hr.
Maximus is currently looking for a Clinical Review Lead Coordinator to join our team. The Lead Coordinator will be responsible for conducting SIS training, managing IRQ and department schedules, as well as ensure quality assessments and scheduling occurs.
This is a hybrid remote opportunity with approximately 30% travel required to complete face to face assessments; must live in the state of Virginia. The remaining 70% of time will be worked from home.
Why join Maximus?
- Competitive Health Benefits
- 401k with Company Match
- Paid Time Off
- Employee Assistance Program (EAP)
- Career Development and Promotional opportunities
Job Description Summary:
This role reviews clinical documentation and requests submitted by individuals and/or providers to determine appropriate level of care and/or prior authorization.
Job Summary:
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.
- Provide training and/or consultation to assigned Clinical Reviewers.
- 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 Experience:
Education and Experience Requirements:
- Education and licensure requirements are based on program contract requirements and are outlined in job posting
- High School Degree or equivalent required
- Minimum 6 years of clinical experience required
- LPN, RN, LCSW, or related license may be required based on contract requirements
Minimum Requirements:
- Bachelor's Degree
- Two (2) to five (5) years leadership experience
- Current certification as a SIS Assessor
- Social Worker licensure preferred
- At least one (1) year experience working with individuals with a wide range of IDD
Home Office Requirements:
- Maximus provides company-issued computer equipment
- Reliable high-speed internet service
- Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
- Minimum 5 Mpbs upload speeds
- Private and secure workspace
#ClinicalServices #RichmondVA #VirginiaHeathcareCoordinator #ClinicalManager #HealthcareCoordinator #PatientCareCoordinator #OperationsManager #QualityImprovement #ClinicalReviewer #CaseManager #CareManager #LeadCoordinator #HealthCoordinator #AssessmentReviewer #ClinicalAssessmentReviewer #IDDAssessor #SISAssessor #OperationsCoordinator #LicenedSocialWorker #HyridRemoteVirginia #Hybrid
MAXIMUS Introduction: Since 1975, Maximus has operated under its founding mission of Helping Government Serve the People, enabling citizens around the globe to successfully engage with their governments at all levels and across a variety of health and human services programs. Maximus delivers innovative business process management and technology solutions that contribute to improved outcomes for citizens and higher levels of productivity, accuracy, accountability and efficiency of government-sponsored programs. With more than 30,000 employees worldwide, Maximus is a proud partner to government agencies in the United States, Australia, Canada, Saudi Arabia, Singapore and the United Kingdom. For more information, visit https://www.maximus.com. EEO Statement: EEO Statement: Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce. We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a difference for our country. We’re proud of our connections to organizations dedicated to serving veterans and their families. If you are transitioning from military to civilian life, have prior service, are a retired veteran or a member of the National Guard or Reserves, or a spouse of an active military service member, we have challenging and rewarding career opportunities available for you. A committed and diverse workforce is our most important resource. Maximus is an Affirmative Action/Equal Opportunity Employer. Maximus provides 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. Pay Transparency: 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. Posted Max: USD $29.00/Hr. Posted Min: USD $17.26/Hr.
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