Remote Medicaid Healthcare Investigator (RN/LSW/LPCC)
Simple Staffing
Staffing Solutions Organization LLC is seeking a Healthcare Investigator I to conduct investigations of Medicaid-related incidents while ensuring compliance with Ohio regulations. This fully remote Ohio position requires collaboration with internal and external stakeholders and independent work in a professional setting. The role emphasizes interviewing, strong documentation, and education of providers on applicable rules, with occasional in-person training in the Central Ohio area. #J-18808-Ljbffr
- ...LLC (SSO) seeks a Registered Nurse Healthcare Investigator to join their Ohio-based remote team. The role focuses on investigating incidents involving Medicaid recipients and providers to protect... ...fully remote within Ohio, hold an Ohio RN license, and conduct thorough...Remote work
- Staffing Solutions Organization LLC is seeking a fully remote Healthcare Investigator licensed in Ohio (RN, LSW/LISW, or LPC/LPCC) to safeguard Medicaid recipients. You will review records, interview stakeholders, and prepare clear investigation summaries while collaborating...Remote job
- ...Organization LLC (SSO) seeks a Licensed Social Worker - Healthcare Investigator in Ohio. The role is fully remote within the state; you must be licensed as an LSW or LISW in Ohio. The position involves investigating Medicaid-related incidents to protect the health and...Remote job
- ...Solutions Organization LLC (SSO) is seeking a Licensed Professional Counselor to join our remote Healthcare Investigator team in Ohio. The role conducts investigations into Medicaid incidents, analyzes documentation, interviews involved parties, and ensures compliance...Remote workLocal areaWork from home
- ...Remote – Must be a licensed LSW, RN, or LPC in the State of Ohio Are you a licensed healthcare professional who’s passionate about... ...impact across Ohio’s Medicaid and HCBS programs.... ...: The Healthcare Investigator plays a critical... ...Counselor (LPC or LPCC) Experience: Minimum...Remote workWork from homeFlexible hours
- ...Organization LLC is seeking a Healthcare Investigator I to conduct thorough... ...into incidents involving Medicaid recipients and providers,... ...are met. This fully remote role supports collaboration... ...candidate holds an Ohio RN, LSW/LISW, or LPC/LPCC license, with at least one...Remote work
$53k - $55k
...Licensed Social Worker - Healthcare Investigator - State of Ohio Work Location: Remote – Must be a licensed as an LSW in the State of... ...involving Medicaid recipients and/or providers... ...Registered Nurse (RN) – Ohio Licensed... ...Counselor (LPC or LPCC) – Ohio...Remote workH1bWork at officeWork from homeFlexible hours- ...Humana is seeking a Fraud and Waste Professional to conduct comprehensive investigations of reported, alleged, or suspected fraud involving the Medicaid program and related healthcare services. This remote role may require occasional travel to Humana offices for training or...Remote work
$62.66k - $84.17k
...in-person home visits, remote coaching and our proprietary... ...The Registered Nurse (RN) Care Manager or Licensed Social Worker (LSW/LISW) Care Manager works... ...with applications for Medicaid, waiver programs, and other... ...role in the future of healthcare—and so can you. Careforth...Remote workFlexible hours$65.97k - $124.99k
A healthcare services provider is seeking a Clinical Fraud Investigator II, requiring an Associate Degree in Nursing and CPC certification. Responsibilities include analyzing... ...clinical fraud investigation. This role offers remote work flexibility within certain commuting...Remote work- ...Personal Care Services assessments for Medicaid beneficiaries in North Carolina. The role is remote but requires residency in NC and... ...submit SARs, and coordinate with healthcare professionals while upholding privacy and dignity. Requires NC RN licensure and NC residency. #J-...Remote workWork from home
- ...TriWest Healthcare Alliance seeks a Transition of Care Coordinator to oversee care transitions for TRICARE beneficiaries. You will coordinate... ...ensure continuity of care and safety. The role requires an RN/LSW/LCSW with a current license, multi-state licensure, U.S....Remote work
- ...Molina Healthcare in Texas is seeking six registered nurses to provide telephonic care management for Medicaid members statewide. Two tracks require at least two years in behavioral... ...ED experience; all roles involve mostly remote work with some in-person visits if needed...Remote work
- ...Registered Nurse to perform needs-based assessments for Medicaid beneficiaries in designated North Carolina... ...home and community settings, coordinate with healthcare professionals, and submit SARs for PCS providers. The RN must maintain NC residency or live within 40...Remote work
$26.06 per hour
Remote Contract (4 months 29 days) Published 3 months ago CLOSED unrestricted RN license NY Medicaid experience LTSS Job ID: JP00046663 Anticipated Start... ...communities - and making healthcare simpler. We are a Fortune... ...oversight to LPN/LVN, LSW, LCSW, LMSW, and other licensed...Remote jobHourly payDaily paidContract workTemporary workFor contractorsWork experience placementLocal area1 day per week- ...Molina Healthcare in Texas seeks six Texas-licensed RNs to work telephonically with Medicaid members across the state. Most interactions are telephonic; rare in-person visits... ...Bilingual candidates are a plus. As a care manager RN, you will support care coordination,...Remote workMonday to Friday
- ...Molina Healthcare is seeking six TX licensed RNs to support Medicaid members telephonically across the state. Roles include care management with 2+ years in BH/SA or ICU/ED, telephonic coordination, and occasional in-person visits. Hours are Mon–Fri, 8–5 in your time zone...Remote work
$58 - $84 per hour
...you if you: Are independently licensed in Ohio as an LPCC, LISW, LIMFT, or PsyD Or if you are an LPC or LSW looking for a collaborative team of supportive... ...the freedom from working from home or in a private remote location Are passionate about ending the stigma around...Remote workHourly payContract workFor contractorsPrivate practiceWork from home- ...UnitedHealth Group is seeking a Clinical Coordinator RN for a Telecommute role in Texas. You will... ...thorough documentation and collaboration within a remote team, with weekday daytime hours. Ideal candidates have Medicaid experience and familiarity with H6516/H2060 assessments...Remote workWeekday work
- ...Nurse to perform needs-based assessments for Medicaid beneficiaries in home or community... ...Carolina counties. The role requires NC RN licensure and residency within NC or within... ...telephonic assessments, collaborate with healthcare professionals, and submit SARs for PCS providers...Remote job
- ...Assessor Registered Nurse to perform needs-based assessments for Medicaid beneficiaries in home or community settings. The role requires... ...face-to-face assessments, submit SARs, and collaborate with healthcare professionals to ensure accurate PCS eligibility...Remote job
$60k
...Associate Mental Health Therapist (LSW, LPCC, or LMFTC)Compensation: Initially $60,000/yr... ...Monday-Friday 8am-5pm. 1 day per week of remote schedule. Location: This is a hybrid role... ...) and FSA options to help manage healthcare and dependent care expenses*Employer-paid...Remote workBi-weekly payFull timeTemporary workWork at officeMonday to Friday1 day per week- ...CoventBridge Integrity Systems seeks an experienced Medicaid claims auditor with an active RN license to review claims for potential fraud. You will... ...coding knowledge to assess payment accuracy and document investigative findings. The role involves preparing detailed...
$65k - $88.6k
...for conducting comprehensive investigations of reported, alleged or... ...involving South Carolina's Medicaid Program. The Fraud and Waste... ...Responsibilities Analyze healthcare payment methodologies, billing... ...Waste Work Style Fully remote in the contiguous US, with...Remote workFull timeTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to Friday- ...Healthcare Fwa InvestigatorLevels (Investigator, Sr. Investigator, etc) will depend on experience and qualifications... ...resultsSupport multiple clients with Medicaid, Medicare, Federal Employee and... ...skillsAbility to work independently within a remote team, under minimal...Remote work
- ...Providing investigative support for special investigation unit activities, the full-time Healthcare Fraud Investigator will focus on the prevention... ..., and abuse, while working remotely. Key responsibilities... ...Knowledge of managed care, Medicaid, Medicare, and claim billing...Remote workFull time
- ...Conduct complex, in-depth investigations of reported fraud involving the full range of healthcare products. Develop and maintain relationships with law enforcement (... ...cases of reported fraud involving the Company’s Medicaid healthcare product. Develop leads from various...Remote workWork experience placement
- ...and Waste Professional to conduct comprehensive investigations of reported or suspected fraud related to Medicaid programs. The role requires coordinating with law... ...provider records to ensure billing integrity. Fully remote in the contiguous US with periodic travel...Remote work
$6,135 per month
.../2026 Agency: Department of Healthcare and Family Services Class Title... ...General, Bureau of Investigations is seeking to hire an energetic... ...abuse involving the Illinois Medicaid program, Child Care Assistance... ...available in many program areas. (Remote work may be an option for...Remote workFull timeContract workFor contractorsWork at officeLocal areaMonday to FridayFlexible hoursNight shift- ...Professional to conduct comprehensive investigations of reported or suspected fraud within Medicaid programs. The role coordinates... .... The position is fully remote in the contiguous US, with... ...Bachelor's degree and 2+ years in healthcare fraud investigations, plus strong...Remote work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Medicaid Healthcare Investigator (RN/LSW/LPCC). Be the first to apply!
- aml investigator Columbus, OH
- federal investigator Columbus, OH
- research investigator Columbus, OH
- surveillance investigator Columbus, OH
- insurance investigator Columbus, OH
- employee relations investigator Columbus, OH
- case investigator Columbus, OH
- defense investigator Columbus, OH
- human rights investigator Columbus, OH
- remote investigator Columbus, OH

