At least 5 years
This role is STARs-friendly: Skilled Through Alternative Routes.
27% STARs in role.
We are hiring for a Nurse Incident Investigator! This is a fully remote position and the role will primarily handle investigating incidents that arise with patients enrolled in Medicaid waiver programs. This is a long-term career opportunity with potential for growth in pay, and is not expected to be just a temporary role.
Candidates MUST have experience handling investigations and knowledge of Ohio's MyCare, Medicaid products and Ohio's incident reporting process. Must be licensed in the state of Ohio in any of the following areas: RN, LSW, LISW, LPC, or LPCC.
Job Title: Nurse Incident Investigator
Job Description
The Nurse Incident Investigator is responsible for the development, implementation, investigation, and oversight of waiver incident reporting at both the individual member and organizational levels. This role leads the full lifecycle of waiver incident management, including education, reporting, investigation, processing, and closure, while ensuring strict compliance with state and federal regulations, provider contracts, and applicable waiver requirements.
Responsibilities
- Develop, coordinate, and maintain initial and ongoing education and training related to waiver incident reporting from start to finish.
- Identify, receive, and process reported waiver incidents in accordance with state and federal regulations, including but not limited to abuse, neglect, misappropriation, exploitation, and health and welfare concerns.
- Ensure all incident reporting and investigation activities align with applicable administrative codes, CMS regulations, and provider agreement requirements.
- Provide oversight of waiver incident management activities conducted in collaboration with the state-contracted investigation organization.
- Independently investigate waiver incidents that do not fall under the responsibility of the state-contracted investigation organization.
- Develop, document, and implement prevention plans and resolutions based on investigation findings to reduce future incidents and improve member safety.
- Audit waiver incidents to ensure completeness, accuracy, and compliance with state and federal requirements in preparation for annual audits.
- Collect and review clinical documentation related to serious incidents, including deaths, and determine outcomes such as Death or Unexplained Death based on available clinical information.
- Escalate cases of Unexplained Death to the appropriate external agency for further review when clinical documentation does not support a clear cause.
- Maintain detailed, timely, and accurate documentation of all incident investigations, findings, and resolutions.
- Collaborate with internal medical management and care management teams to ensure coordinated responses to incidents and to support quality improvement efforts.
- Perform other related duties as assigned while complying with all organizational policies, procedures, and standards.
Qualifications:
- Current licensure as an RN, LSW, LISW, LPC, or LPCC.
- A Bachelors Degree in Nursing, Social Work, and/or Counseling.
- At least five years of relevant professional experience (may be somewhat flexible on years of experience).
- Relevant experience should include knowledge of Ohio's MyCare, Medicaid products and Ohio's incident reporting process.
Job Type & Location
This is a Contract position based out of Columbus, OH.
Pay and BenefitsThe pay range for this position is $34.00 - $41.00/hr.
Eligibility requirements apply to some benefits and may depend on your job
classification and length of employment. Benefits are subject to change and may be
subject to specific elections, plan, or program terms. If eligible, the benefits
available for this temporary role may include the following:
• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)
This is a fully remote position.
Application DeadlineThis position is anticipated to close on Jun 4, 2026.
About Actalent
Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.
San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.
Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.
Posting ID: JP-006042232
