Healthcare Investigator

Job not on LinkedIn

🔥 6 minutes ago

🏈 Ohio – Remote

🏈 Ohio – Remote

💵 $48k - $53k / year

⏰ Full Time

🟢 Junior

✨ Investigator

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Dayforce

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

👥 HR Tech

☁️ SaaS

🏢 Enterprise

💰 $1G Post-IPO Debt - Dayforce on 2024-03

HR Tech • SaaS • Enterprise

Dayforce is a cloud-based human capital management (HCM) platform that provides payroll, workforce management, time and attendance, HR, benefits, and talent management capabilities delivered as a SaaS solution for employers. It is designed to help organizations manage the employee lifecycle, automate payroll and workforce processes, and provide analytics for workforce planning and compliance.

📋 Description

• Conducts investigations of reported incidents involving Medicaid recipients and providers to ensure health and welfare standards are met • Reviews and analyzes documentation including clinical records, incident reports, billing records, and other relevant materials • Performs interviews with recipients, providers, witnesses, and other involved parties using effective interviewing and active-listening techniques • Accurately documents all investigative activities, findings, and conclusions in the incident reporting system • Identifies rule violations, contributing factors, and potential risks; develops clear, well-supported investigation summary reports • Educates Medicaid providers on applicable rules, responsibilities, and best practices related to service delivery • Coordinates and refers cases to external entities as appropriate • Gathers information and prepares referrals to the Ohio Department of Medicaid for suspected or egregious provider misconduct • Maintains professionalism and confidentiality while working independently in a remote environment

🎯 Requirements

• Licensed Registered Nurse (RN) – Ohio • Licensed Social Worker (LSW or LISW) – Ohio • Licensed Professional Counselor (LPC or LPCC) – Ohio • Minimum of 1 year of paid experience in Home and Community-Based Services (HCBS), including incident investigation, ensuring individual health and welfare, quality assurance or clinical risk management, mental health or addiction services, interfacing with law enforcement, nursing homes, children services, adult protective services, or the Ohio Department of Developmental Disabilities, providing waiver services • Strong critical-thinking and analytical skills • Excellent organizational skills • Strong verbal and written communication skills • Effective interviewing and active-listening abilities • Ability to work independently and collaboratively

🏖️ Benefits

• Medical, dental, and vision insurance • 401(k) with discretionary employer match • Paid time off and holidays • Flexible spending accounts • Additional employee perks