Remote Nurse Incident Investigator

Job Title

Nurse Incident Investigator

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.

• 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 support quality improvement efforts.
• Perform other related duties as assigned while complying with all organizational policies, procedures, and standards.

• 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.

This is a Contract to Hire position based out of Columbus, OH.

The 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, benefits available for this temporary role may include:

• 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.

This position is anticipated to close on May 5, 2026.

Actalent is an equal opportunity employer.