Onsite Reviewer

Staffing Solutions Organization LLC; Kentucky; On-site; USD 65,000 - 95,000; Full time

Benefits offered by this job

Medical Insurance

Vision Insurance

401(k) with Employer Match

Paid Time Off

Paid Holidays

Flexible Spending Accounts

Job summary

Staffing Solutions Organization (SSO) seeks an Onsite Reviewer to ensure Ohio Medicaid providers operate from approved locations and remain compliant with ODM standards. The role conducts in-person assessments using ODM-approved checklists across the state.

You will travel daily, may stay overnight, document findings with professional reporting, interview providers, and collaborate with a QA team to uphold quality standards and timely reviews.

Qualifications

• Bachelor's Degree required.
• Valid driver's license with an acceptable driving record.
• Willingness and ability to travel extensively throughout Ohio.
• Experience using tablets/iPads and Microsoft Office applications.
• Strong written communication, documentation, and dictation skills.
• Excellent organizational, time management, and analytical skills.
• Demonstrated ability to work independently with minimal supervision.

Responsibilities

• Conduct onsite reviews of Ohio Medicaid provider locations throughout the state.
• Travel daily to provider sites and complete assigned review schedules.
• Execute ODM-approved site review checklists and conduct provider interviews in accordance with established protocols.
• Assess provider operations, documentation practices, and regulatory compliance requirements.
• Document site visit findings accurately, thoroughly, and professionally using proper grammar, punctuation, and objective observations.
• Submit completed reviews within established quality assurance and compliance deadlines.
• Analyze collected information and provide recommendations regarding provider enrollment or continued participation in Medicaid programs.
• Maintain strict confidentiality regarding provider information, findings, and review outcomes.
• Meet established productivity, quality, and customer service performance standards.
• Work independently while effectively managing priorities, deadlines, and travel schedules.
• Address provider questions and concerns professionally and identify opportunities for process improvement.
• Utilize technology, tablets, and reporting systems to document and complete reviews.
• Represent the organization professionally during all provider interactions.

Education

Bachelor's Degree

Tools

Tablets/iPads

Microsoft Office

Job description

The Onsite Reviewer plays a critical role in ensuring Ohio Medicaid providers deliver legitimate services, maintain compliance with Ohio Administrative Code requirements, and operate from approved service locations. Using a comprehensive site review checklist approved by the Ohio Department of Medicaid (ODM), the Onsite Reviewer conducts independent, in-person provider assessments while collaborating with a larger quality assurance team.

This position requires extensive daily travel throughout Ohio, with occasional overnight stays based on assigned territories and schedules.

Key Responsibilities

• Conduct onsite reviews of Ohio Medicaid provider locations throughout the state.
• Travel daily to provider sites and complete assigned review schedules.
• Execute ODM-approved site review checklists and conduct provider interviews in accordance with established protocols.
• Assess provider operations, documentation practices, and regulatory compliance requirements.
• Document site visit findings accurately, thoroughly, and professionally using proper grammar, punctuation, and objective observations.
• Submit completed reviews within established quality assurance and compliance deadlines.
• Analyze collected information and provide recommendations regarding provider enrollment or continued participation in Medicaid programs.
• Maintain strict confidentiality regarding provider information, findings, and review outcomes.
• Meet established productivity, quality, and customer service performance standards.
• Work independently while effectively managing priorities, deadlines, and travel schedules.
• Address provider questions and concerns professionally and identify opportunities for process improvement.
• Utilize technology, tablets, and reporting systems to document and complete reviews.
• Represent the organization professionally during all provider interactions.

Required Qualifications;

• Bachelor's Degree required.
• Valid driver's license with an acceptable driving record.
• Willingness and ability to travel extensively throughout Ohio.
• Experience using tablets/iPads and Microsoft Office applications.
• Strong written communication, documentation, and dictation skills.
• Excellent organizational, time management, and analytical skills.
• Demonstrated ability to work independently with minimal supervision.
• Professional demeanor with strong interpersonal, listening, and communication skills.

Preferred Experience:

Minimum of two (2) years of experience in one or more of the following areas:

• Public Health
• Critical Care
• Home Health
• Long-Term Care (LTC)
• Behavioral Health or Mental Health Services
• Developmental Disabilities Services
• Children's Services
• Elder Care Services
• Community Social Services

In addition, experience in one or more of the following is preferred:

• Medicaid programs
• Provider monitoring or auditing
• Compliance reviews
• Third-party billing
• Provider training and education
• Healthcare operations
• Quality assurance

Successful candidates will be:

• Honest, dependable, and self-motivated.
• Comfortable working independently in the field.
• Detail-oriented with strong investigative and observational skills.
• Skilled at analyzing information and making objective recommendations.
• Able to maintain professionalism while navigating challenging situations.
• Customer-focused with excellent problem-solving abilities.

Benefits Through Staffing Solutions Organization (SSO)

SSO offers a competitive benefits pake hat may include:

• Medical Insurance
• Vision Insurance
• 401(k) with Employer Match
• Paid Time Off (PTO)
• Paid Holidays
• Flexible Spending Accounts (FSA)
• Employee Assistance Program (EAP)
• Additional Employee Perks

Keywords Search

Ohio Medicaid, Healthcare Compliance, Provider Review, Site Auditor, Healthcare Auditor, Field Reviewer, Quality Assurance, Medicaid Provider Enrollment, Regulatory Compliance, Home Health, Long-Term Care, Public Health, Behavioral Health, Provider Monitoring, Healthcare Operations, Field-Based Position, Statewide Travel, Documentation Review, Healthcare Inspection, Medicaid Compliance.