Clinical Reviewer LPN - (Remote)

Clinical Reviewer LPN - (Remote)

Job Posting Title Clinical Reviewer LPN - (Remote) Date Monday, October 5, 2026 City Remote Country United States Working time Full-time

Essential Duties and Responsibilities

- Review requests for services, including admissions, discharges, and continued stays for adherence to clinical criteria, state and federal policy, and contract requirements involving broad clinical complexity and variability; escalate complex and non-standard cases that are exceptions to policies.- Issue approvals, denials, or recommendations based on contract requirements, applying judgment and analysis to interpret guidelines in non-routine cases.- Identify the need for additional clinical documentation or consultation and analyze information gaps to support accurate and timely determinations.- Complete accurate documentation of review activities within contract systems.- Communicate with providers, individuals and their designees, or state workers as required.- Serve as an internal resource to team members within established processes.- May write high-quality, fully substantiated clinical determination reports by synthesizing assessment findings, interview data, and supporting documentation, including completing the summary of findings.

Minimum Requirements

Specific clinical license and experience requirements based on contract requirements. EEO Statement Maximus is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics. 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. Maximus will comply with regulatory minimum wage rates and exempt salary thresholds in all instances. Minimum Salary $ 26.80 Maximum Salary $ 29.57