Healthcare Compliance Invest 2

Public Consulting Group

Raleigh, NC

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JOB DETAILS

SALARY

$65,000–$95,000 Per Year

SKILLS

Case Management, Child Protection/Welfare, Child and Youth Services, Communication Skills, Computer Skills, Consulting, Customer Relations, Data Collection, Department of Health and Human Services, Detail Oriented, Developmental Disabilities, Government, Health Education, Healthcare, Healthcare Quality, Interviewing Skills, Investigative Reports, Law Enforcement, Legal, Medicaid, Medical Genetics, Microsoft Excel, Microsoft Outlook, Microsoft Word, Military, Nursing Home, Operational Improvement, Organizational Skills, Presentation/Verbal Skills, Protective Services, Psychiatry and Mental Health, Quality Assurance, Registered Nurse (RN), Reporting Skills, Risk Management, Social Work, Team Player, Time Management, Writing Skills

LOCATION

Raleigh, NC

POSTED

30+ days ago

Public Consulting Group LLC (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health, education, and human services agencies to improve lives. Founded in 1986, PCG employs approximately 2,000 professionals throughout the U.S.—all committed to delivering solutions that change lives for the better. The firm is a member of a family of companies with experience in all 50 states, and clients in three Canadian provinces and Europe. PCG offers clients a multidisciplinary approach to meet challenges, pursue opportunities, and serve constituents across the public sector. To learn more, visit www.publicconsultinggroup.com .

Duties and Responsibilities

+ Assumes more difficult cases, bundles

+ Trains new investigators on managing work flow

+ Investigates incidents pertaining to Medicaid recipients and/or their providers with the purpose of ensuring health and welfare

+ Educates Medicaid providers of all applicable rules, responsibilities, and best practices related to providing services to Medicaid recipients

+ Conducts thorough investigations of all incidents and violations including a review of all relevant documentation, billing, and interviews with all individuals who may have relevant information, document all investigative activities, including discovery of all elements of the incident in the incident reporting system

+ Makes referrals to and coordinate investigations with law enforcement, county children's services, adult protective units, county board of developmental disabilities, or any other entity as needed

+ Writes investigation summary reports identifying all contributing factors and work with Case Manager to approve a prevention plan to mitigate risk and ensure health and welfare of the individual

+ Gathers information to write and submit referrals to Ohio Department of Medicaid for egregious provider behavior

+ All other duties as assigned per departmental need

Required Skills

+ Demonstrated ability to think critically, incorporating multiple factors into larger concepts

+ Strong organizational skills with abilities to simultaneously manage multiple investigations

+ Demonstrated ability to work with and relate to others with customer relation techniques,

+ professionalism and with respect for other cultures

+ Demonstrated effective active listening and interviewing skills

+ Strong computer skills with competence in MS Word, Excel, and Outlook

+ Demonstrated ability to foster teamwork with all levels of management and staff

+ Demonstrated ability to work well independently and within a team

+ Superior verbal and written communication skills

+ Strong and independent decision making skills, with accuracy and attention to detail

+ Ability to successfully work in multiple programs and projects.

+ Demonstrated excellent time management, initiative self-direction, and accountability

Qualifications

+ Licensed registered nurse (RN), a licensed social worker (LSW, LISW), or a licensed professional counselor (LPC, LPCC)

+ 3+ years paid experience in home and community based service (HCBS), specifically experience with any of the following: incident investigation, assuring individual health and welfare, quality assurance, clinical risk management, the mental health system, or interfacing with law enforcement, nursing homes, children services, adult protective services, or the Department of Developmental Disabilities

+ RN, LSW, LISW, LPC, LPCC

Working Conditions

+ Office or Remote Setting

The above is intended to describe the general contents and requirements of work being performed by people assigned to this classification. It is not intended to be construed as an exhaustive statement of all duties, responsibilities or skills of personnel so classified.

Compensation:

Compensation for roles at Public Consulting Group varies depending on a wide array of factors including, but not limited to, the specific office location, role, skill set, and level of experience. As required by applicable law, PCG provides a reasonable range of compensation for this role. In addition, PCG provides a range of benefits for this role, including medical and dental care benefits, 401k, PTO, parental leave, bereavement leave.

Range: $65,000 - $95,000

PCG does not sponsor newly hired foreign national workers for work authorization, including H-1B sponsorship.

EEO Statement:

Public Consulting Group is an Equal Opportunity Employer dedicated to celebrating diversity and intentionally creating a culture of inclusion. We believe that we work best when our employees feel empowered and accepted, and that starts by honoring each of our unique life experiences. At PCG, all aspects of employment regarding recruitment, hiring, training, promotion, compensation, benefits, transfers, layoffs, return from layoff, company-sponsored training, education, and social and recreational programs are based on merit, business needs, job requirements, and individual qualifications. We do not discriminate on the basis of race, color, religion or belief, national, social, or ethnic origin, sex, gender identity and/or expression, age, physical, mental, or sensory disability, sexual orientation, marital, civil union, or domestic partnership status, past or present military service, citizenship status, family medical history or genetic information, family or parental status, or any other status protected under federal, state, or local law. PCG will not tolerate discrimination or harassment based on any of these characteristics. PCG believes in health, equality, and prosperity for everyone so we can succeed in changing the ways the public sector, including health, education, technology and human services industries, work.
Public Consulting Group is an equal opportunity employer. All qualified applicants receive consideration for employment without regard to race, color, religion, gender, national origin, age, sexual orientation, gender identity, protected veteran status, or status as a qualified individual with a disability. VEVRAA Federal Contractor.

About the Company

Public Consulting Group

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