HCBS Incident Investigator

Spectraforce Technologies; Columbus (OH); Remote; USD 60,000 - 75,000; Full time

Job summary

A leading company is seeking an HCBS Incident Investigator to review incidents and collaborate with care coordination teams. This role requires strong clinical skills and knowledge of Ohio Medicaid regulations. The position is remote and offers a chance for extension.

Qualifications

• Knowledge of OH Medicaid and MyCare regulations.
• 2 years of clinical experience required.

Responsibilities

• Review submitted incidents for appropriateness.
• Create incidents within Ohio's Incident Management system.
• Collaborate with care coordination teams.

Skills

Critical thinking

Self-motivated

Strong clinical background

Ability to work independently

Ability to collaborate

Fast learner

Computer savvy

Education

Master's in SW or therapy

RN

Tools

Microsoft Excel

Microsoft Outlook

Job description

Title: HCBS Incident Investigator

Location: Remote OH

Duration: 3 months (possibility to extend/convert)

Job description:

1. Review submitted incidents for appropriateness.
2. Create incidents within Ohio's Incident Management system, documenting in EMR-TruCare.
3. Call regulatory, protective, and law enforcement agencies as needed.
4. Collaborate with care coordination teams, ODM's contracted investigative entity, and ODM's care coordination team.

Education/Certification

• Required: Master's in SW or therapy, or RN
• Preferred: [Specify if any]

Licensure

• Required: Ohio license
• Preferred: [Specify if any]

Experience

• Must haves: Knowledge of OH Medicaid and MyCare regulations, managed care contracts, and 2 years of clinical experience.
• Nice to haves: Behavioral health background, knowledge of Microsoft Excel and Outlook, OH incident reporting, area of agency on aging, OH Managed Care.

Performance indicators

Employee is expected to submit incidents and ensure these are followed through and closed within the time period specified in MyCare's 3-way contract with CMS and the Ohio Department of Medicaid.

Top 3 must-have hard skills

1. Critical thinking, self-motivated, strong clinical background
2. Ability to work independently and collaboratively in a team
3. Fast learner, computer savvy