*********Minimum Requirements: - High School Degree and 2+ years clinical experience required; Associate's Degree preferred or equivalent combination of education or experience - Current Licensed Practical Nurse (LPN) OR Current Registered Nurse (RN) licenses valid in the state of practice is required - Minimum 1 year of clinical experience required - Proficient understanding and experience with Microsoft products; Word, Excel, PowerPoint, Outlook required - Excellent organizational, written, and verbal communication skills - Ability to quickly learn and proficiently use multiple project-related computer applications - Ability to multi-task and quickly adapt and perform in a fast-paced work environment. Preferred Qualifications - Prior experience in Utilization Management - Knowledge of health regulations, guidelines, and coverage issues Home Office Requirements - Candidates must have their own cell phone. - 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 #ClinicalServices #LI-Remote
Essential Duties and Responsibilities: -Review medical documentation to ensure sufficiency to allow for completion of clinical summary template - Complete clinical summary template - Review requested treatments to ensure accurate entry - Review expert specialty designation for accuracy; escalate case for any questions/concerns outside normal case processing - Perform other duties as assigned
Best Value
%20(2).svg){kind=small}
Advanced
%20(1).svg){kind=small}
Basic
.svg)
.svg)
.svg)
.svg)
.svg)
