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Posted May 12, 2026

Hybrid Clinical Reviewer II - PASRR (Southeast Region in MA) presso Un – USA Remote Jobs

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  • Upon suspicion of SMI conduct in-person evaluations to confirm the presence of SMI, whether a nursing facility is the most appropriate setting and whether the individual has a need for behavioral health, rehabilitative or specialized services
  • Conduct completed evaluations prior to individuals nursing facility admissions; completed evaluations on individuals residing in a nursing facility when there are significant changes that signify the need for an updated evaluation;completed annual evaluations for individuals who have a previously confirmed SMI; complete abbreviated desk reviews as indicated or needed
  • Complete evaluations on an individualized basis within required timeframes, and in accordance with the most current federal rules, regulations, and evaluative criteria
  • Communicate all evaluation findings to applicants, residents and/or legally authorized representatives in an understandable manner and language
  • Communicate determinations that identity a need for specialized services and/or behavioral health services to the facility, agency, or referrals source, within appropriate timelines and data transmission policies
  • Contact providers, state agency offices, and applicants/participants to obtain information and records needed to conduct a comprehensive clinical review of the case and final determination
  • Review and document all relevant information into data system applications in accordance with program guidelines and regulations
  • Maintain individual records documenting all applicant/participant encounters and contacts; write clinical summaries
  • Support in the preparation and responses to requests for statistics and resource/service data
  • Foster and promote continuity of care and cooperative partnerships by liaising with health care providers, acute care hospitals, long term care facilities and other programs/organizations involved in the provision of services
  • Participate in public relations efforts, attending conferences and meetings as needed
  • Maintain positive working relationships with applicant/participants, and relevant informal supports, provider organizations, program consultants and state agencies
  • Maintain the confidentiality of all business documents and correspondence per UMass Chan Medical School/ForHealth Consulting procedures and HIPAA regulations
  • Participate in performance improvement initiatives and demonstrate the use of quality improvement in daily operations
  • Comply with established departmental policies, procedures and objectives
  • Comply with all health, safety and program regulations and requirements


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