Licensed Professional Counselor – Healthcare Investigator

This is a fully remote position, open to applicants in Ohio.

📋 Description

• Conduct investigations into reported incidents involving Medicaid recipients and providers to ensure compliance with health and welfare standards.

• Analyze clinical records, incident reports, billing documents, and other pertinent information.

• Interview recipients, providers, witnesses, and other parties involved in cases.

• Record investigative activities, findings, and conclusions within the incident reporting system.

• Identify violations of rules, contributing factors, and potential risks.

• Create comprehensive and well-supported summary reports of investigations.

• Provide education to Medicaid providers regarding relevant rules, responsibilities, and best practices in service delivery.

• Coordinate and make referrals to law enforcement, county children's services, Adult Protective Services, county boards of developmental disabilities, and other oversight or regulatory bodies.

• Collect information and prepare referrals to the Ohio Department of Medicaid for suspected or severe provider misconduct.

• Uphold professionalism and confidentiality while working autonomously in a remote setting.

• Perform additional duties as assigned to meet departmental needs.

⛳️ Requirements

• Must hold a valid LPC or LPCC license in the State of Ohio.

• A minimum of 1 year of paid experience in Home and Community-Based Services (HCBS).

• Experience in incident investigation, ensuring individual health and welfare, quality assurance or clinical risk management, mental health or addiction services, interfacing with law enforcement, nursing homes, children services, adult protective services, or the Ohio Department of Developmental Disabilities, or providing waiver services.

• Strong analytical and critical-thinking abilities.

• Excellent organizational skills with the capacity to manage multiple investigations simultaneously.

• Strong verbal and written communication skills, including professional report writing.

• Proficient in interviewing and active listening techniques.

• Ability to work both independently and collaboratively within a team setting.

• Strong decision-making skills with an emphasis on accuracy and attention to detail.

• Professional demeanor and the ability to interact respectfully with individuals from diverse backgrounds.

• Proficiency in Microsoft Word, Excel, Outlook, and web-based systems.

• Willingness to work standard business hours with flexibility based on investigative requirements.

• Capability to work remotely within Ohio and travel occasionally within the Central Ohio region for training purposes.

🏝️ Benefits

• Quarterly performance bonuses.

• Medical, dental, and vision insurance.

• 401(k) plan with discretionary employer matching.

• Paid time off and holidays.

• Flexible spending accounts.

• Additional perks for employees.