Maximus · 19 hours ago
Clinical Reviewer RN (Remote in TN)
United States
Full-time
Remote
Entry, Mid Level
$33/hr - $37.12/hr
2+ years expMaximus is seeking a Clinical Reviewer (Registered Nurse) to support the Tennessee Appeals area of the contract. In this role, the RN Clinical Reviewer is responsible for reviewing clinical cases, applying nursing judgment and regulatory guidelines, and ensuring each case is accurately assessed and routed to the appropriate department or escalated as needed.
Business Process Automation (BPA)ConsultingEducationGovernmentGovTechHealth CareInformation Technology
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
Qualification
Required
Current Registered Nurse (RN) license valid in the state of practice is required
High School Degree or equivalent required
Minimum 2 years of clinical experience required
Minimum of one (1) year of registered nurse experience
Preferred
Knowledge of mental health principles and practices
Experience in physical rehabilitation
Attention to detail
Benefits
Work/Life Balance Support - Flexibility tailored to your needs!
Competitive Compensation - Bonuses based on performance included!
Comprehensive Insurance Coverage - Choose from various plans, including Medical, Dental, Vision, Prescription, and partially funded HSA. Additionally, enjoy Life insurance benefits and discounts on Auto, Home, Renter's, and Pet insurance.
Future Planning - Prepare for retirement with our 401K Retirement Savings plan and Company Matching.
Paid Time Off Package – Enjoy PTO, Holidays, and extended sick leave, along with Short and Long Term Disability coverage.
Holistic Wellness Support - Access resources for physical, emotional, and financial wellness through our Employee Assistance Program (EAP).
Recognition Platform - Acknowledge and appreciate outstanding employee contributions.
Tuition Reimbursement - Invest in your ongoing education and development.
Employee Perks and Discounts - Additional benefits and discounts exclusively for employees.
Maximus Wellness Program and Resources - Access a range of wellness programs and resources tailored to your needs.
Professional Development Opportunities-Participate in training programs, workshops, and conferences.
Licensures and Certifications-Maximus assumes the expenses associated with renewing licenses and certifications for its employees.
Company
Maximus
Providing government technology services, digitally enabled customer experiences, and clinical health services that change lives.
10001+ employees
H1B Sponsorship
Maximus has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (32)
2024 (39)
2023 (50)
2022 (42)
2021 (36)
2020 (42)
Funding
Current Stage
Public CompanyTotal Funding
$7.93M2010-12-09Post Ipo Equity· $7.93M
Leadership Team
Elisabeth Schmidt
Senior Vice President
Michael Mateer
Sr. Vice President, Enterprise Technology
Recent News
2025-11-20
Company data provided by crunchbase