HCBS Incident Investigator

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  Review submitted incidents for appropriateness.

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

  
  
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  Calling regulatory, protective and law enforcement agencies as needed.

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

  
  

Background & Context:

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  Staff member going out on medical leave.

  
  
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  Recent increase in incident submission.

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

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

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

  
  

Key Responsibilities:

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  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:

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  Required Education: Master's in Social Work (SW) or Therapy - but RN is also acceptable.

  
  
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  Licensure: OH license required.

  
  
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  Years of Experience: 2 years of clinical experience.

  
  
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  Must-Haves:

  
  
  
  
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    OH license

    
    
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    Knowledge of OH Medicaid and MyCare regulations

    
    
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    Experience with managed care contracts

    
    
  
  
  
  
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  Nice-to-Haves:

  
  
  
  
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    Behavioral health background

    
    
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    Knowledge of Microsoft Excel and Outlook

    
    
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    Ohio incident reporting experience

    
    
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    Experience with Area Agency on Aging

    
    
  
  
  
  
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  Top 3 Hard Skills:

  
  
  
  
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     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