Sr Consultant - Nursing Survey (CA DMHC Medical Survey) - Maximus

Maximus is currently hiring for a Senior Consultant - Nursing Survey to join our State West - CA DMHC Medical Survey team. This is a remote opportunity.

Essential Duties and Responsibilities:

Pre-onsite: Prepare to survey (audit) managed healthcare plan offices in utilization management, emergency services, pharmacy, grievances and appeals, access and availability, and language assistance.

- Review and analyze managed healthcare plan documents, including but not limited to policies, procedures, organizational charts, meeting minutes, training, and job aids.

- Complete the client-developed audit tool which walks the surveyor through clinical and legal requirements for managed healthcare plan operations - perform detailed analysis, fact-finding, and documentation of evidentiary support for findings.

- Perform detailed case file review to audit if the plan is performing as indicated in its policies and complete the client-developed tool which walks the surveyor through clinical and legal requirements.

- Attend pre-onsite meetings with client team to discuss preliminary findings.

On-site: Prepare for and interview plan staff at managed healthcare plan offices.

- Travel to plan offices in the survey area and lead interviews with plan staff (including CEOs and Medical Directors) and client team (team lead, oversight manager and attorney), in order to obtain relevant evidence to support findings.

Post-onsite: Complete and update audit tools with information obtained through the site visit.

- Identify potential plan deficiencies for survey area.

- Request additional documentation and/or interviews, as needed.

- Draft report of deficiencies for survey area.

- Address feedback and/or questions from the client regarding findings in the report.

Additional responsibilities:

- Participate in interviewing clinical candidates to increase project staff, as needed.

- Support the project by training new clinical staff, creating/updating job aids, and holding meetings to review new client and/or legislative requirements that impact survey work.

- Support new survey staff through the entire survey process and provide instruction/oversight both remotely and onsite.

- Edit project reports and ensure findings in the reports are supported by evidence which is correctly cited in accordance with client requirements. Project reports are a key client deliverable and the ability to edit only comes with significant experience in both performing the survey work and writing reports.

- Review other surveyor's work to ensure client deliverable requirements are met, as needed.

- As requested by the client, provide input to survey tool updates, suggest survey process improvements, and support new survey process developments in response to new legislative and regulatory requirements.

- Experience supporting Maximus in a Sr Consultant - Nursing Survey (CA DMHC Medical Survey) experience required

Minimum Requirements

- Bachelor's Degree or equivalent experience.
- 5-7 years of related professional experience.

- Nursing degree required.

Please note: For this position Maximus will provide equipment to use.

Home Office Requirements:

- Internet speed of 20mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)

- Minimum 5mpbs upload speed

- Connectivity to the internet via either Wi-Fi or Category 5 or 6 ethernet patch cable to the home router

- Private work area and adequate power source

- Must currently and permanently reside in the Continental US

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.

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.

Annual Base Pay Minimum for this Position

$

53,500.00

Annual Base Pay Maximum for this Position

$

78,000.00