Clinical Review Lead Coordinator, LPN/RN

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. *********Minimum Requirements: - High School Degree and 2+ years clinical experience required; Associate's Degree preferred or equivalent combination of education or experience.

Join our California Independent Medical Review (CA IMR) team as a Lead Coordinator - Clinical Review, LPN/RN, supporting the review of workers’ compensation medical cases. In this fully remote, non-bedside role, you’ll use your nursing experience to review and interpret medical records, identify key clinical information, and prepare clear, accurate summaries for expert review.

At Maximus, we are committed to cultivating a positive and inclusive work environment, and we are pleased to offer the following:

Work/Life Balance Support - Flexibility tailored to your needs!

Comprehensive Insurance Coverage - Medical, Dental, Vision, Life insurance, and enjoy 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.

Diversity, Equity, and Inclusion Initiatives - Join a workplace committed to fostering diversity and inclusion.

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.

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

*********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

- Experience reviewing and interpreting clinical documentation, including physician and progress notes.
- Strong written communication skills with the ability to produce clear, grammatically accurate summaries.
- Proficiency with Microsoft Word, Excel, PowerPoint, and Outlook and ability to learn multiple computer applications.

Preferred Skills

- Experience with clinical review, utilization management, or appeals.

- Knowledge of healthcare regulations, guidelines, or coverage issues.

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.

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.