Healthcare Investigator

🔥 1 minute ago

🏈 Ohio – Remote

🏈 Ohio – Remote

💵 $53k - $55k / year

⏰ Full Time

🟢 Junior

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Staffing Solutions Organization LLC

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2017

🎯 Recruiter

🏛️ Government

💼 Consulting

Recruitment • Government • Consulting

Staffing Solutions Organization LLC is a staffing and talent‑management firm that delivers high‑impact recruiting and workforce solutions primarily for public‑sector agencies and organizations. The company’s services include rapid staffing and scaling, talent matching, and hands‑on consulting and program management to design, launch, and run workforce programs. Staffing Solutions markets nationwide reach (800+ experts), rapid scalability (examples of 140 hires in 24 days and 652 onboarded in 7 days), and claims 15,000+ staff recruited since 2017; it positions itself as a partner to help agencies maximize the potential of their people.

📋 Description

• Investigate reported incidents involving Medicaid recipients and providers to ensure health and welfare standards are met • Review and analyze clinical records, incident reports, billing records, and other relevant 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 to support departmental needs

🎯 Requirements

• Must hold one Ohio license: Registered Nurse (RN), Social Worker (LSW or LISW), or Professional Counselor (LPC or LPCC) • Minimum of 1 year of paid experience in Home and Community-Based Services (HCBS) • Experience in incident investigation, individual health and welfare, quality assurance, clinical risk management, mental health or addiction services, relevant agency coordination, or waiver services • Strong critical-thinking and analytical skills • Ability to synthesize complex information • 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 within a team environment • Strong decision-making skills, accuracy, and attention to detail • Demonstrated professionalism and ability to work respectfully with diverse individuals • Proficiency with Microsoft Word, Excel, Outlook, and internet-based systems • Must live/work within Ohio • Ability to accommodate occasional travel 1–2 times per year within Central Ohio for training • Ability to work standard business hours with flexibility based on investigative needs • Ability to handle sensitive or emotionally challenging information

🏖️ Benefits

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