6,639 Hybrid Remote jobs in the United States

Job Title: Physician Advisor

The Physician Advisor works collaboratively with case managers, social workers, and admitting physicians to ensure patients are placed at the correct level of care and that medical necessity is well-documented. The PA also addresses issues around clinical documentation, billing compliance (including CMS 2-Midnight Rule), length of stay, readmissions, and quality metrics. This position reports through a matrix structure to the Corporate Physician Advisor, Chief Quality and Integration Officer (CQIO), and entity-level CMO/CEO.

Key Responsibilities:

Provide real-time clinical guidance to ensure appropriate level of care and utilization

Support accurate clinical documentation to reflect severity of illness and medical necessity

Collaborate with providers and hospital staff to improve care transitions and reduce LOS/readmissions

Conduct post-discharge audits and respond to payer reviews or appeals

Educate medical staff on CMS regulations, InterQual/MCG criteria, and billing requirements

Drive clinical practice improvements that enhance patient care and hospital performance

Promote interdepartmental collaboration and communication through education and support

Maintain knowledge of current compliance standards and payer guidelines through ongoing education

Qualifications:

MD or DO degree from an accredited institution

Active medical license in Florida

Minimum 3 years of clinical practice experience

Experience with medical necessity reviews and use of MCG or InterQual criteria

Knowledge of CMS Conditions of Participation, billing regulations, and the 2-Midnight Rule

Strong communication, organization, and critical thinking skills

Certifications:

Board Certification by ABQAURP (or equivalent) required within 1 year of hire

Physician Advisor Certification preferred at time of hire

Additional Skills:

Ability to manage multiple deadlines and shifting priorities

Proficiency in relevant technology and EMR systems

Ability to lead and educate in both individual and group settings

Demonstrated professionalism and sound clinical judgment

The Physician Advisor works collaboratively with case managers, social workers, and admitting physicians to ensure patients are placed at the correct level of care and that medical necessity is well-documented. The PA also addresses issues around clinical documentation, billing compliance (including CMS 2-Midnight Rule), length of stay, readmissions, and quality metrics. This position reports through a matrix structure to the Corporate Physician Advisor, Chief Quality and Integration Officer (CQIO), and entity-level CMO/CEO.

Key Responsibilities:

Provide real-time clinical guidance to ensure appropriate level of care and utilization

Support accurate clinical documentation to reflect severity of illness and medical necessity

Collaborate with providers and hospital staff to improve care transitions and reduce LOS/readmissions

Conduct post-discharge audits and respond to payer reviews or appeals

Educate medical staff on CMS regulations, InterQual/MCG criteria, and billing requirements

Drive clinical practice improvements that enhance patient care and hospital performance

Promote interdepartmental collaboration and communication through education and support

Maintain knowledge of current compliance standards and payer guidelines through ongoing education

Qualifications:

MD or DO degree from an accredited institution

Active medical license in Florida

Minimum 3 years of clinical practice experience

Experience with medical necessity reviews and use of MCG or InterQual criteria

Knowledge of CMS Conditions of Participation, billing regulations, and the 2-Midnight Rule

Strong communication, organization, and critical thinking skills

Certifications:

Board Certification by ABQAURP (or equivalent) required within 1 year of hire

Physician Advisor Certification preferred at time of hire

Additional Skills:

Ability to manage multiple deadlines and shifting priorities

Proficiency in relevant technology and EMR systems

Ability to lead and educate in both individual and group settings

Demonstrated professionalism and sound clinical judgment

Who You Are

Sr. Network with FabricRemote is OK or  Engineer - Hybrid on site

Santa Clara, CA

Maximus is seeking a detail-oriented and compassionate Regional Clinical Assessor to join our team. In this role, you will conduct assessments and provide intake counseling for individuals participating in Medicaid Waiver and Long-Term Services and Supports programs. The successful candidate will ensure assessments and counseling are completed in accordance with state directives, Maximus processes, and regulatory timeframes. This position offers the opportunity to make a meaningful impact by helping individuals access vital support services.

This position does not require a clinical license.

Please note: This position will be working for Maximus through a 3rd party vendor

About the Program

The Indiana Level of Care Assessment and Referral (IN LCAR) program is a statewide initiative focused on evaluating and determining the appropriate level of care for individuals seeking long-term services and support. The program ensures that individuals receive assessments tailored to their needs, facilitates connections to the appropriate resources, and supports efficient transitions between care settings. As part of a collaborative team, professionals in this program play a critical role in improving access to services and promoting quality outcomes for the people of Indiana.

Essential Duties and Responsibilities:
- Responsible for completing medical and/or behavioral health assessments within contract requirements
- Conducts on-site, video call and/or telephonic assessments to determine an individual's needs for services and supports, eligibility, level of care or related outcome
- Perform all job duties in compliance with Person First standards, HIPAA guidelines, and company confidentiality policies and procedures.
- Travel may be required based on program contract requirements
- Performs other related duties as assigned.

- Preferred knowledge may include community support programs, long-term care assessment and level of care in medical, behavioral health or related programs
- Knowledge and understanding of medical and/or behavioral health diagnoses and prescribed medications
- Ability to collect data, define problems, establish facts, and draw valid conclusions

Minimum Requirements

- Education and licensure requirements are based on program contract requirements and are outlined in job posting
- High School Degree or equivalent required
- Minimum 2 years of clinical experience required
- LPN, RN, LCSW, or related licensure may be required based on contract requirements

- RN license or a degree (Associate's in nursing, Bachelor's in health/social work/related field, or a master's in any field).

- Minimum of one (1) year of experience in the human services field.

-Familiar with behavioral health diagnoses, psychotropic medications, and medical diagnoses.

- Ability to assess individual needs effectively and provide accurate counseling regarding available support options.

- Strong multitasking skills with the ability to prioritize and manage a high volume of tasks.

- Proficiency in Microsoft Office Suite (Word, Outlook, Excel) and comfortable working with various digital tools.

- Ability to work independently and as part of a team in a fast-paced environment.

- Strong written and verbal communication skills, with the ability to interact professionally with internal teams and external providers.

Preferred Requirements

- Prior experience using interRAI assessment system

- Experience working with Medicaid Waiver, Long-Term Services, and Supports, or similar programs.

- Knowledge of state-specific regulations related to Medicaid Waiver and other support services.

- Familiarity with Person First standards and HIPAA compliance in healthcare settings.

- Additional certifications related to social work, healthcare, or human services are a plus.

Home Office Requirements

-Maximus provides company-issued computer equipment

-Reliable high-speed internet service

-Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity

-Minimum 5 Mpbs upload speeds

-Private and secure workspace

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.

Accommodations
Maximus provides reasonable accommodations to individuals requiring assistance during any phase of the employment process due to a disability, medical condition, or physical or mental impairment. If you require assistance at any stage of the employment process-including accessing job postings, completing assessments, or participating in interviews,-please contact People Operations at .

Minimum Salary

$

28.00

Maximum Salary

$

34.00

Who You Are

Sr. Network with FabricRemote is OK or  Engineer - Hybrid on site

Santa Clara, CA

Maximus is seeking a detail-oriented and compassionate Regional Clinical Assessor to join our team. In this role, you will conduct assessments and provide intake counseling for individuals participating in Medicaid Waiver and Long-Term Services and Supports programs. The successful candidate will ensure assessments and counseling are completed in accordance with state directives, Maximus processes, and regulatory timeframes. This position offers the opportunity to make a meaningful impact by helping individuals access vital support services.

This position does not require a clinical license.

Please note: This position will be working for Maximus through a 3rd party vendor

About the Program

The Indiana Level of Care Assessment and Referral (IN LCAR) program is a statewide initiative focused on evaluating and determining the appropriate level of care for individuals seeking long-term services and support. The program ensures that individuals receive assessments tailored to their needs, facilitates connections to the appropriate resources, and supports efficient transitions between care settings. As part of a collaborative team, professionals in this program play a critical role in improving access to services and promoting quality outcomes for the people of Indiana.

Essential Duties and Responsibilities:
- Responsible for completing medical and/or behavioral health assessments within contract requirements
- Conducts on-site, video call and/or telephonic assessments to determine an individual's needs for services and supports, eligibility, level of care or related outcome
- Perform all job duties in compliance with Person First standards, HIPAA guidelines, and company confidentiality policies and procedures.
- Travel may be required based on program contract requirements
- Performs other related duties as assigned.

- Preferred knowledge may include community support programs, long-term care assessment and level of care in medical, behavioral health or related programs
- Knowledge and understanding of medical and/or behavioral health diagnoses and prescribed medications
- Ability to collect data, define problems, establish facts, and draw valid conclusions

Minimum Requirements

- Education and licensure requirements are based on program contract requirements and are outlined in job posting
- High School Degree or equivalent required
- Minimum 2 years of clinical experience required
- LPN, RN, LCSW, or related licensure may be required based on contract requirements

- RN license or a degree (Associate's in nursing, Bachelor's in health/social work/related field, or a master's in any field).

- Minimum of one (1) year of experience in the human services field.

-Familiar with behavioral health diagnoses, psychotropic medications, and medical diagnoses.

- Ability to assess individual needs effectively and provide accurate counseling regarding available support options.

- Strong multitasking skills with the ability to prioritize and manage a high volume of tasks.

- Proficiency in Microsoft Office Suite (Word, Outlook, Excel) and comfortable working with various digital tools.

- Ability to work independently and as part of a team in a fast-paced environment.

- Strong written and verbal communication skills, with the ability to interact professionally with internal teams and external providers.

Preferred Requirements

- Prior experience using interRAI assessment system

- Experience working with Medicaid Waiver, Long-Term Services, and Supports, or similar programs.

- Knowledge of state-specific regulations related to Medicaid Waiver and other support services.

- Familiarity with Person First standards and HIPAA compliance in healthcare settings.

- Additional certifications related to social work, healthcare, or human services are a plus.

Home Office Requirements

-Maximus provides company-issued computer equipment

-Reliable high-speed internet service

-Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity

-Minimum 5 Mpbs upload speeds

-Private and secure workspace

#ClinicalServices

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.

Accommodations
Maximus provides reasonable accommodations to individuals requiring assistance during any phase of the employment process due to a disability, medical condition, or physical or mental impairment. If you require assistance at any stage of the employment process-including accessing job postings, completing assessments, or participating in interviews,-please contact People Operations at .

Maximus is seeking an Clinical IDD Assessor to join our team. The IDD Assessor will be responsible for conducting field IDD/SIS assessments as well as ensuring quality standards, supporting activities, and attending monthly assessor calls. This is a hybrid remote opportunity with 75% travel required; must live in or very near to one of the following cities in Maine: Cumberland, Oxford, York and Portland area.

About the program: Maximus has been contracted to partner with the State of Maine Department of Health and Human Services - Office of Aging and Disability Services (OADS) to administer the Supports Intensity Scale for Adults (SIS-A) Assessments. This comprehensive planning tool measures exceptional medical and behavioral needs, as well as the areas of home living, community living, lifelong learning, employment, health and safety, and social activities.

Why Maximus?

- 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 em

Essential Duties and Responsibilities:

- Responsible for completing medical and/or behavioral health assessments within contract requirements
- Conducts on-site, video call and/or telephonic assessments to determine an individual's needs for services and supports, eligibility, level of care or related outcome
- Perform all job duties in compliance with Person First standards, HIPAA guidelines, and company confidentiality policies and procedures.
- Travel may be required based on program contract requirements
- Performs other related duties as assigned.

Required Skills/Abilities:
- Preferred knowledge may include community support programs, long-term care assessment and level of care in medical, behavioral health or related programs
- Knowledge and understanding of medical and/or behavioral health diagnoses and prescribed medications
- Ability to collect data, define problems, establish facts, and draw valid conclusions

Minimum Requirements

- Education and licensure requirements are based on program contract requirements and are outlined in job posting
- High School Degree or equivalent required
- Minimum 1 year of clinical experience required

- Bachelor's degree in Human Services or related field

- A minimum of one (1) year of direct experience working with individuals with intellectual and/or developmental disabilities or Autism and successful experience conducting assessments in the field

-Obtain SIS-A certification upon completion of training

Preferred Requirements

- QIDP-Qualified Intellectual Disability Professional or similar experience helpful.

- ISP-Individual Support Plan experience a plus.

Home Office Requirements:

-Maximus provides company-issued computer equipment and cell phone

-Reliable high-speed internet service

-Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity

-Minimum 5 Mpbs upload speeds

#ClinicalServices

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.

Accommodations
Maximus provides reasonable accommodations to individuals requiring assistance during any phase of the employment process due to a disability, medical condition, or physical or mental impairment. If you require assistance at any stage of the employment process-including accessing job postings, completing assessments, or participating in interviews,-please contact People Operations at .

Minimum Salary

$

27.00

Maximum Salary

$

27.00

Maximus is seeking a detail-oriented and compassionate Regional Clinical Assessor to join our team. In this role, you will conduct assessments and provide intake counseling for individuals participating in Medicaid Waiver and Long-Term Services and Supports programs. The successful candidate will ensure assessments and counseling are completed in accordance with state directives, MAXIMUS processes, and regulatory timeframes. This position offers the opportunity to make a meaningful impact by helping individuals access vital support services.

Please note: This position will be working for Maximus through a 3rd party vendor

About the Program

The Indiana Level of Care Assessment and Referral (IN LCAR) program is a statewide initiative focused on evaluating and determining the appropriate level of care for individuals seeking long-term services and support. The program ensures that individuals receive assessments tailored to their needs, facilitates connections to the appropriate resources, and supports efficient transitions between care settings. As part of a collaborative team, professionals in this program play a critical role in improving access to services and promoting quality outcomes for the people of Indiana.

Essential Duties and Responsibilities:
- Responsible for completing medical and/or behavioral health assessments within contract requirements
- Conducts on-site, video call and/or telephonic assessments to determine an individual's needs for services and supports, eligibility, level of care or related outcome
- Perform all job duties in compliance with Person First standards, HIPAA guidelines, and company confidentiality policies and procedures.
- Travel may be required based on program contract requirements
- Performs other related duties as assigned.

- Preferred knowledge may include community support programs, long-term care assessment and level of care in medical, behavioral health or related programs
- Knowledge and understanding of medical and/or behavioral health diagnoses and prescribed medications
- Ability to collect data, define problems, establish facts, and draw valid conclusions

Minimum Requirements

- Education and licensure requirements are based on program contract requirements and are outlined in job posting
- High School Degree or equivalent required
- Minimum 2 years of clinical experience required
- LPN, RN, LCSW, or related licensure may be required based on contract requirements

- RN license or a degree (Associate's in nursing, Bachelor's in health/social work/related field, or a master's in any field).

- Minimum of one (1) year of experience in the human services field.

-Familiar with behavioral health diagnoses, psychotropic medications, and medical diagnoses.

- Ability to assess individual needs effectively and provide accurate counseling regarding available support options.

- Strong multitasking skills with the ability to prioritize and manage a high volume of tasks.

- Proficiency in Microsoft Office Suite (Word, Outlook, Excel) and comfortable working with various digital tools.

- Ability to work independently and as part of a team in a fast-paced environment.

- Strong written and verbal communication skills, with the ability to interact professionally with internal teams and external providers.

Preferred Requirements

- Prior experience using InterRAI assessment system

- Experience working with Medicaid Waiver, Long-Term Services, and Supports, or similar programs.

- Knowledge of state-specific regulations related to Medicaid Waiver and other support services.

- Familiarity with Person First standards and HIPAA compliance in healthcare settings.

- Additional certifications related to social work, healthcare, or human services are a plus.

Home Office Requirements

-Maximus provides company-issued computer equipment

-Reliable high-speed internet service

-Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity

-Minimum 5 Mpbs upload speeds

-Private and secure workspace

#ClinicalServices

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.