Clinical Reviewer, Rn Or Lpn (remote - Tn)

Maximus

Remote, TN, United States
Base: not specified; bonus/equity: bonuses based o...
On-site
Clinical documentation review
Prior authorization determination
Pasrr program support
Maximus partners with the State of Tennessee to conduct Preadmission Screening and Resident Review (PASRR), a federally mandated process to determine appropriate nursing facility care and connect individuals with needed services

Job Summary

  • Maximus partners with the State of Tennessee to conduct Preadmission Screening and Resident Review (PASRR), a federally mandated process to determine appropriate nursing facility care and connect individuals with needed services.
  • This role involves reviewing clinical requests, issuing approvals or denials, and ensuring compliance with clinical criteria and policies to support Medicaid-certified nursing homes.
  • Maximus offers competitive compensation including bonuses, comprehensive insurance coverage, paid time off, retirement plans with company matching, and tuition reimbursement.

Matching Summary

Maximus partners with the State of Tennessee to conduct Preadmission Screening and Resident Review (PASRR), a federally mandated process to determine appropriate nursing facility care and connect individuals with needed services.

Salary

Base: Not specified; Bonus/Equity: Bonuses based on performance included; Benefits: Comprehensive insurance, 401K with company matching, PTO, disability coverage, tuition reimbursement

Skills & Requirements

Must-have

  • Clinical documentation review
  • Prior authorization determination
  • PASRR program support
  • Microsoft Office Suite proficiency
  • Remote work with secure workspace
  • Clinical assessment and judgment

Nice-to-have

  • Experience with utilization management platforms
  • Electronic medical records proficiency
  • Strong written and verbal communication
  • Professional development opportunities
  • Work/life balance support
  • Employee wellness programs

Key Requirements

  • Active unrestricted RN or LPN license valid in Tennessee or compact license with privileges
  • Minimum 2 years clinical experience in RN or LPN role
  • High School Degree or equivalent
  • Proficiency in Microsoft Office and Adobe
  • Reliable high-speed internet with minimum speeds
  • Private and secure home workspace

Work Rights

Not specified

Tailored Resume

Cover Letter