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Clinical Reviewer - CAP Multidisciplinary Team

at Maximus

Posted: 8/14/2019
Job Reference #: 39540
Keywords:

Job Description

  • Job LocationsUS-NC-Raleigh
    Posted Date4 months ago(5/3/2019 1:36 PM)
    Requisition ID
    2019-39540
    # of Openings
    10
    Job Schedule
    Regular Full-Time
  • Job Description Summary

    SUMMARY
    Review completed assessments for individuals with medical conditions or cognitive impairments living in private residence or assisted living and requesting in-home personal care services to assist with activities of daily living. Assessments include review of records, individual interview, interview of significant caregiver and/or family members, obtaining key copies of medical records, and completing required assessment and summary reports.

    ESSENTIAL FUNCTIONS:
    • Responsible for reviewing desk-based second-level review of assessments for individuals with medical conditions and/or cognitive impairments which impact their participation in daily living activities.
    • Responsible for completing and submitting assessment reviews within the respective timeline, adhering to quality benchmarks and contractual specifications, utilizing computer database system
    • Must work within a tight turnaround time assuring contract compliance
    • Completes other job duties as assigned or necessary
    JOB REQUIREMENTS
    Knowledge, Skills & Abilities
    • Perform all job duties in compliance with Person First standards, HIPAA guidelines, and company confidentiality policies and procedures
    • Ability to multitask effectively while performing job duties, including ability to prioritize tasks and ensuring all voice mail and email messages are returned within contract standards
    • Ability to work independently with minimal day-to-day supervision
    • Excellent written and verbal communication skills
    • Excellent interpersonal skills
    • Ability to interact professionally and collegially with referral sources (hospital & nursing home staff, physicians, social service workers, etc.), state contract officers, and coworkers
    • Ability to define problems, collect data, establish facts, and draw valid conclusions
    • Intermediate skill with word processing and spreadsheet software (Microsoft Word and Excel preferred)
    Education
    The job requires a Social Worker licensed in North Carolina.

    Experience
    The job requires experience at least three (3) years of experience in intellectual and development disability, chronic disease, or other health care and/or social science discipline.

     

    • High School Diploma with 0-2 years of experience.
    • May have additional training or education in area of specialization.
    • Works on assignments that are routine in nature, with responsibilities easily learned on the job.
    • Acquires job skills and learns applicable policies and procedures to complete routine tasks.
    • Able to read, understand & perform assignments within prescribed guidelines.
    • Communicates routine information in a clear and accurate way with internal & external contacts.

     

    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’re 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.
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