Licensed Social Worker – Healthcare Investigator

Staffing Solutions Organization LLC

. Investigate reported incidents involving Medicaid recipients and providers .

Posted 10/14/2026full-timeRemote • Ohio • United StatesJunior💰 $53,000 - $55,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in incident investigation and analysis, with a strong focus on Medicaid regulations and provider compliance. Proficient in preparing detailed reports and coordinating with oversight agencies while maintaining professionalism and confidentiality.

Highest-signal resume keywords

Licensed Social Worker (LSW) in OhioIncident Investigation ExperienceHome and Community-Based Services (HCBS)Strong Verbal and Written Communication SkillsProficiency with Microsoft Office Suite

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Incident InvestigationClinical Record ReviewQuality AssuranceRisk ManagementReport WritingData AnalysisInterviewing SkillsCritical ThinkingDecision MakingAttention to Detail

Soft Skills

Organizational SkillsActive ListeningProfessionalismCollaborationFlexibility

Tools & Technologies

Microsoft WordMicrosoft ExcelMicrosoft OutlookInternet-Based Systems

Certifications & Qualifications

Licensed Social Worker (LSW)Registered Nurse (RN)Licensed Professional Counselor (LPC)Licensed Professional Clinical Counselor (LPCC)Licensed Independent Social Worker (LISW)

Industry Keywords

MedicaidHome and Community-Based Services (HCBS)Provider ComplianceOversight AgenciesProtective Services

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 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
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

Must be licensed as an LSW in the State of Ohio; the posting also accepts an Ohio RN, LPC, LPCC, or LISW
Minimum of 1 year of paid experience in Home and Community-Based Services (HCBS)
Experience in incident investigation, individual health and welfare, quality assurance or clinical risk management, mental health or addiction services, relevant protective/oversight agency interaction, or 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
Ability to work standard business hours with flexibility based on investigative needs

Benefits

Comp & perks

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