Clinical Reviewer

This is a fully remote position, open to applicants in Illinois.

📋 Description

• Assess evaluations and determine the needs of individuals for additional supports and services.

• Perform quality control evaluations of field assessors' work to guarantee accuracy and compliance.

• Analyze routine service requests, such as admissions, discharges, and continued stays, utilizing established clinical criteria, state and federal policies, and contractual obligations.

• Refer complex or non-standard cases that fall outside defined protocols for further review.

• Provide approvals, denials, or recommendations in accordance with contract stipulations and standardized decision-making frameworks.

• Recognize the need for supplementary clinical documentation or consultation and seek advice from senior personnel.

• Ensure timely and precise documentation of review activities in contractual systems.

• Engage in communication with providers, individuals and their representatives, or state workers.

• Draft substantiated clinical determination reports by integrating assessment results, interview data, and supporting documentation, including findings summaries.

• Assist the Illinois SALT program and assessment processes for PASRR Level I screens and Level II SMI evaluations.

⛳️ Requirements

• A high school diploma or GED is required, along with a minimum of 2 years of relevant professional experience, or an equivalent combination of education and experience.

• A Master’s degree in counseling, social work, psychology, or a closely related field, or an active, unrestricted RN license is necessary.

• At least two (2) years of post-graduate work experience within the mental health sector is required.

• A minimum of two (2) years' experience in conducting mental health assessments is essential.

• Proficiency in Microsoft Office applications is required.

• Exceptional interpersonal and verbal communication abilities are necessary.

• Strong written communication skills, with the ability to produce concise and impactful documentation, are needed.

• IM+CANS certification or a willingness to obtain it is required.

• Strong computer skills are essential.

• Familiarity with PASRR is necessary.

• Reliable high-speed internet service is required.

• Minimum download speeds of 20 Mbps/50 Mbps for shared internet connectivity are necessary.

• Minimum upload speeds of 5 Mbps are required.

• A private and secure workspace is needed.

🏝️ Benefits

• Support for work/life balance with flexibility.

• Performance-based bonuses.

• Comprehensive medical, dental, vision, and prescription insurance.

• Partially funded Health Savings Account (HSA).

• Life insurance benefits.

• Discounts on auto, home, renter's, and pet insurance.

• 401K Retirement Savings plan with company matching.

• Paid time off, holidays, and extended sick leave.

• Coverage for short- and long-term disability.

• Employee Assistance Program (EAP) for physical, emotional, and financial well-being.

• Recognition platform.

• Tuition reimbursement.

• Employee perks and discounts.

• Maximus Wellness Program and resources.

• Opportunities for professional development, including training programs, workshops, and conferences.

• Company-issued computer equipment.