Healthcare Investigator

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🔥 1 minute ago

🏈 Ohio – Remote

🏈 Ohio – Remote

💵 $53k - $55k / year

⏰ Full Time

🟢 Junior

👻 Ghost score 0%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Simple Staffing Group

WebsiteLinkedInAll Job Openings

2 - 10 employees

Founded 2024

👥 HR Tech

🎯 Recruiter

🤝 B2B

HR Tech • Recruitment • B2B

Simple Staffing Group is a Las Vegas–headquartered firm that provides staffing and technology-enabled workforce solutions to enterprise customers worldwide. They offer temporary staffing, permanent recruitment, specialized (high-skilled) recruitment across industries including tech, finance, and skilled trades, contract and temp-to-perm hiring, direct placement, outsourcing, national engagements, talent development, and career-transition services. They serve clients from startups to Fortune 500/900 companies, emphasize compliance and ethical standards, and promote flexible engagement models and digital tools to connect job seekers with employers.

📋 Description

• Investigate reported incidents involving Medicaid recipients and providers • Review and analyze clinical records, incident reports, billing records, and other documentation • Interview recipients, providers, witnesses, and other involved parties • Document investigative activities, findings, and conclusions in the incident reporting system • Identify rule violations, contributing factors, and potential risks • Prepare clear, well-supported investigation summary reports • Educate Medicaid providers on applicable rules, responsibilities, and service-delivery best practices • Coordinate and refer cases to law enforcement, county children services, Adult Protective Services, county Boards of Developmental Disabilities, and other oversight agencies • Gather information and prepare referrals to the Ohio Department of Medicaid for suspected or egregious provider misconduct • Maintain professionalism and confidentiality while working independently in a remote environment • Perform other duties as assigned

🎯 Requirements

• Must be a licensed RN, LSW, LPCC, or LPC in the State of Ohio • Minimum of 1 year of paid experience in Home and Community-Based Services (HCBS) • Experience in incident investigation, ensuring individual health and welfare, quality assurance or clinical risk management, mental health or addiction services, interfacing with law enforcement or relevant protective/regulatory services, or providing waiver services • Strong critical-thinking and analytical skills • Excellent organizational skills and ability to manage multiple investigations concurrently • Strong verbal and written communication skills, including professional report writing • Effective interviewing and active-listening abilities • Ability to work independently and collaboratively • Strong decision-making skills, accuracy, and attention to detail • Professionalism and ability to work respectfully with diverse individuals • Proficiency with Microsoft Word, Excel, Outlook, and internet-based systems • Standard business hours with flexibility based on investigative needs

🏖️ Benefits

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

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