Maximus is hiring a Clinical Coordinator. This role reviews clinical documentation and requests submitted by individuals and/or providers to determine appropriate level of care and/or prior authorization.
*This is a REMOTE position but must have North Carolina licensure or Compact licensure.
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, longterm 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 fastpaced environment
Ability to work independently and meet timelines
EDUCATION AND EXPERIENCE:
North Carolina LCSW, LCMHC or equivalent
OR RN license
Active, unrestricted licensure in the state of North Carolina or compact licensure required
LCSW or LCMHC required education Masters
2 years of clinical experience preferred
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
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
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 are 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 MIN: USD $14.42/Hr.
POSTED MAX: USD $32.00/Hr.
As a leading strategic partner to governments across the globe, Maximus helps improve the delivery of public services amid complex technology, health, economic, environmental, and social challenges. With a deep understanding of program service delivery, acute insights that achieve operational excellence, and an extensive awareness of the needs of the people being served, our employees advance the critical missions of our partners. Maximus delivers innovative business process management, impactful consulting services, and technology solutions that provide improved outcomes for the public and higher levels of productivity and efficiency of government-sponsored programs.