Incident Management Investigator

Job Summary

Conducting clinical case investigations, the full-time Incident Management Investigator will interview members and stakeholders, develop care plans, and collaborate with various internal departments while working remotely.

Key responsibilities:

• Conduct thorough investigations by interviewing members, caregivers, and facility staff
• Develop and implement member care plans, including education and corrective actions
• Collaborate with internal departments and external agencies to identify and address fraud, waste, and abuse

Required qualifications:

• Associate's degree or equivalent relevant work experience
• Two years of experience in healthcare operations, care coordination, or management
• Intermediate proficiency in Microsoft Office applications
• Knowledge of Medicaid and Medicare preferred
• Ability to maintain confidentiality and organize workload effectively