Title: HCBS Incident Investigator
Location: Remote, Ohio
Duration: 03 months potential to extend
Shift: Mon-Fri 8-5 No OT

Job description:
 

• Review submitted incidents for appropriateness.

• Create incidents within Ohio’s Incident Management system, documenting in Client's EMR-TruCare.

• Calling regulatory, protective and law enforcement agencies as needed.

• Collaborating with care coordination teams, ODM’s contracted investigative entity and ODM’s care coordination team.

Background & Context:

• Staff member going out on medical leave.

• Recent increase in incident submission.

• The team is very independent but always stepping in to assist one another.

• This team fulfills ODM’s requirement for submitting, reviewing and mitigating incidents among the Medicaid and MyCare population for Ohio.

• We may be looking at additional positions in the near future.

Key Responsibilities:

• Submit incidents and ensure follow-through and closure within the required time per MyCare’s contract with CMS and Ohio Department of Medicaid.

Qualification & Experience:

• Required Education: Master’s in Social Work (SW) or Therapy — but RN is also acceptable.

• Licensure: OH license required.

• Years of Experience: 2 years of clinical experience.

• Must-Haves:

  • OH license

  • Knowledge of OH Medicaid and MyCare regulations

  • Experience with managed care contracts

• Nice-to-Haves:

  • Behavioral health background

  • Knowledge of Microsoft Excel and Outlook

  • Ohio incident reporting experience

  • Experience with Area Agency on Aging

• Top 3 Hard Skills:

  1. Critical thinking, strong clinical background

  2. Self-motivated and works independently and in teams

  3. Tech-savvy and a quick learner
     
      

     Candidate Requirements
     Education/Certification	Required: Master’s in SW or therapy, but can have RN			Preferred:
     Licensure	Required:			Preferred:
     Years of experience required Disqualifiers Best vs. average Performance indicators		Must haves: OH license, knowledge of OH Medicaid and MyCare regulations and managed care contracts. 2 years 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   Disqualifiers: TBD   Performance indicators: Employee is expected to submit incidents and ensure that these are followed through and closed within the time period given in MyCare’s 3 way contract CMS and Ohio Department of Medicaid and Medicaid’s contract with the state of Ohio   Best vs. average:
     Top 3 must-have hard skills Level of experience with each Stack-ranked by importance Candidate Review & Selection		1	Critical thinking, self-motivated, strong clinical background
     		2	Must be independent, yet works well with a team
     		3	Fast learner, computer savvy

 

 


At SPECTRAFORCE, we are committed to maintaining a workplace that ensures fair compensation and wage transparency in adherence with all applicable state and local laws. This position’s starting pay is: $27.00/hr.