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Simple Staffing GroupCore Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in incident investigation and analysis, with a focus on Medicaid regulations and provider misconduct. Proficient in report writing, critical thinking, and maintaining confidentiality while working independently and collaboratively.
Highest-signal resume keywords
Licensed Registered Nurse (RN) – OhioLicensed Social Worker (LSW or LISW) – OhioLicensed Professional Counselor (LPC or LPCC) – OhioIncident Investigation ExperienceHome and Community-Based Services (HCBS) Experience
About the role
Key responsibilities & impact- Investigate reported incidents involving Medicaid recipients and providers
- 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 or regulatory 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
What you’ll need- Licensed Registered Nurse (RN) – Ohio, or Licensed Social Worker (LSW or LISW) – Ohio, or Licensed Professional Counselor (LPC or LPCC) – 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 relevant agencies, 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 within a team environment
- Strong decision-making skills, accuracy, and attention to detail
- Professionalism and ability to work respectfully with individuals from diverse backgrounds
- Proficiency with Microsoft Word, Excel, Outlook, and internet-based systems
Benefits
Comp & perks- Medical, dental, and vision insurance
- 401(k) with discretionary employer match
- Paid time off and holidays
- Flexible spending accounts
- Additional employee perks
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Incident InvestigationClinical Risk ManagementQuality AssuranceMental Health ServicesAddiction ServicesReport WritingCritical ThinkingAnalytical SkillsDecision-MakingAttention to Detail
Soft Skills
Organizational SkillsEffective InterviewingActive ListeningProfessionalismCollaboration
Tools & Technologies
Microsoft WordMicrosoft ExcelMicrosoft OutlookInternet-Based Systems
Certifications & Qualifications
Licensed Registered Nurse (RN) – OhioLicensed Social Worker (LSW or LISW) – OhioLicensed Professional Counselor (LPC or LPCC) – Ohio
Industry Keywords
MedicaidHome and Community-Based Services (HCBS)Provider MisconductIncident ReportingRegulatory Agencies