Investigator

• 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 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

Explore Healthcare Investigator at Simple Staffing Group. Review requirements and application details.

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