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Healthcare Compliance Reviewer (Medicaid Provider Oversight) - Ohio

Staffing Solutions Organization LLCToledo, OH, United States
Full-timeFull-time

Healthcare Compliance Reviewer (Medicaid Provider Oversight).Field-based in Ohio - 3 Openings.The Onsite Reviewer plays a critical role in ensuring Ohio Medicaid providers deliver legitimate servic... Show more

LPN

Founders Care & RehabilitationPerrysburg, OH
Full-time +1Full-time +1

Founders Care & Rehabilitation -.If you are compassionate and love to take care of people, then we invite you to consider us as your new employer.We are needing RNS and LVNS for all hours full and ... Show more

Locum Physician Assistant (PA) - Cardiology - Electrophysiology in Mayfield Heights, OH

LocumJobsOnlineToledo, Ohio, US
$160,000.00–$175,000.00 yearly$160,000.00–$175,000.00 yearly
Full-timeFull-time

Physician Assistant | Cardiology - Electrophysiology.Competitive weekly pay (inquire for details).LocumJobsOnline is working with Adelphi Locums to find a qualified Cardiac Electrophysiology PA in ... Show more

 • Promoted

Accounting Manager

Trilon GroupMaumee, Ohio, US
Full-timeFull-time
Quick Apply

MSG) is a people focused, award-winning, full-service consulting firm that offers a wide array of services including civil and geotechnical engineering, environmental consulting, planning, landscap... Show more

Cook/Dietary Aide

Majestic Care Commons at PerrysburgPerrysburg, OH
Full-timeFull-time

Majestic Care Commons at Perrysburg -.Majestic Care Commons at Perrysburg is looking for a Cook and Dietary Aide to join our team's mission and believe in our core values! Our mission:.Through... Show more

Remote Mechanical Engineer

Micro1Maumee, Ohio, US
RemoteRemote
Full-timeFull-time

AI labs & Enterprises train foundational models and agents.We provide frontier evaluations and reinforcement learning environments to improve LLM capabilities, as well as contextual evaluations to ... Show more

 • Promoted

Salesforce & Applications Administrator

The University of Toledo FoundationToledo, OH, US
Full-timeFull-time
Quick Apply

The Salesforce & Applications Administrator serves as the primary administrator and application owner for the Foundation’s Salesforce platform and supports the administration of other ent... Show more

Online Casino Tester- work-from-home

ReeledgeTemperance, Michigan, United States
$25.00 hourly$25.00 hourly
RemoteRemote
Full-timeFull-time

Join our distributed team and help evaluate online platforms through interactive testing assignments.This is a flexible, remote opportunity with full training provided and no prior experience requi... Show more

 • Promoted

Oracle HCM Cloud Manager

ClifyXToledo, OH, United States
Full-timeFull-time

Locations Negotiable (Fulltime travelling position with Client) IL - Chicago, IN - Indianapolis, MI - Detroit, MN - Minneapolis, MN - St Paul, OH - Cincinnati, OH - Columbus - Cleveland, OH - MO - ... Show more

SAP Financial Trade in TRM Lead -Remote With Travel

The Dignify Solutions, LLCMaumee, OH, United States
TemporaryTemporary

Financial Trade in TRM (Futures/Swap/Options) Lead.Prepare/Explore Phase Only - Advisory with Customer and SI.Work with Partner to activate CM/CTRM SAP best practice business processes (configurati... Show more

Package Handler - Part Time (Warehouse like)

FedExPerrysburg, Ohio, US
$19.90–$20.90 hourly$19.90–$20.90 hourly
Full-time +1Full-time +1

Come for a job and stay for a career! Federal Express Corporation (FEC) is part of the rapidly growing warehouse and transportation sector that helps keep America, and our economy, moving.Be part o... Show more

Mobile Health/Hep C Tester (Toledo)

Central Outreach Wellness CenterToledo, OH, United States
$40,000.00–$90,000.00 yearly$40,000.00–$90,000.00 yearly
Full-timeFull-time

Mobile Health/Hep C Tester (Toledo).Toledo Ohio - Toledo, OH 43537.Base+Commission/year Position Type Full Time Job Shift Day Travel Percentage Road Warrior.Are you passionate about patient care an... Show more

Sorter Processor

The Salvation ArmyToledo, Ohio, United States
$11.00 hourly$11.00 hourly
Part-timePart-time
Quick Apply

The Toledo Salvation Army is seeking clothing sorters to perform a variety of functions in order to assist in the operation of the clothing sorting area of our Toledo Production Center.Assist as re... Show more

Registered Nurse

Divine Rehabilitation and Nursing Center at ToledoToledo, OH
Full-timeFull-time

Divine Rehabilitation and Nursing Center at Toledo -.We are seeking a compassionate and skilled Registered Nurse to join our team at Divine Rehabilitation and Nursing Center at Toledo.As a Register... Show more

Project Manager

SSOE GroupToledo, OH, United States
$100,000.00–$120,000.00 yearly$100,000.00–$120,000.00 yearly
Full-timeFull-time

SSOE is looking for a Project Manager for our Process Operations team.This person will play a critical role in winning and executing projects within the industry for a diverse list of leading-edge ... Show more

Glass Production Worker

AllegionPerrysburg, OH
Full-timeFull-time

Creating Peace of Mind by Pioneering Safety and Security.Glass Processor – Technical Glass Products – Perrysburg, OH.Allegion is seeking a Glass Processor to fulfill a full-time position in Perrysb... Show more

Physical Therapist Assistant - PTA

Synchrony RehabPerrysburg, OH, United States
Full-timeFull-time

We believe in setting our employees up for success.That's why we believe in providing an orientation personalized to your work environment.Even when your orientation period ends, you can rest assur... Show more

Remote Inbound Customer Service

Arise Virtual SolutionsToledo, Ohio
RemoteRemote
Full-timeFull-time

If you have worked in customer services and looking for flexible and varied work, consider a new financial services program on the Arise® Platform.This program needs customer-focused individuals to... Show more

 • Promoted

Licensed Practical Nurse LPN

Majestic Care of ToledoToledo, OH
Full-timeFull-time

Majestic Care of Toledo is looking for Licensed Practical Nurses to join our team's mission and believe in our core values! Our mission:.Through the hearts of our Care Team Members, we provide exce... Show more

Travel Reservation Support Representative

HRS Talent SolutionsToledo, OH, USA
$30.00 hourly$30.00 hourly
RemoteRemote
Full-timeFull-time
Quick Apply

Travel Reservation Support Representative.A customer asks whether a reservation is confirmed, where to find the itinerary, or how to request a change.The Travel Reservation Support Representative c... Show more

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Healthcare Compliance Reviewer (Medicaid Provider Oversight) - Ohio

Healthcare Compliance Reviewer (Medicaid Provider Oversight) - Ohio

Staffing Solutions Organization LLCToledo, OH, United States
24 days ago
Job type
  • Full-time
Job description

Healthcare Compliance Reviewer (Medicaid Provider Oversight)

Field-based in Ohio - 3 Openings

Locations:

1 - Akron/Canton/Youngstown area

1 - Columbus

1 - Toledo area

Employment Type: Full-Time

Pay Rate: $25.00 per hour

About the Role:

The Onsite Reviewer plays a critical role in ensuring Ohio Medicaid providers deliver legitimate services, maintain compliance with Ohio Administrative Code requirements, and operate from approved service locations. Using a comprehensive site review checklist approved by the Ohio Department of Medicaid (ODM), the Onsite Reviewer conducts independent, in-person provider assessments while collaborating with a larger quality assurance team.

This position requires extensive daily travel throughout Ohio, with occasional overnight stays based on assigned territories and schedules.

Key Responsibilities

  • Conduct onsite reviews of Ohio Medicaid provider locations throughout the state.
  • Travel daily to provider sites and complete assigned review schedules.
  • Execute ODM-approved site review checklists and conduct provider interviews in accordance with established protocols.
  • Assess provider operations, documentation practices, and regulatory compliance requirements.
  • Document site visit findings accurately, thoroughly, and professionally using proper grammar, punctuation, and objective observations.
  • Submit completed reviews within established quality assurance and compliance deadlines.
  • Analyze collected information and provide recommendations regarding provider enrollment or continued participation in Medicaid programs.
  • Maintain strict confidentiality regarding provider information, findings, and review outcomes.
  • Meet established productivity, quality, and customer service performance standards.
  • Work independently while effectively managing priorities, deadlines, and travel schedules.
  • Address provider questions and concerns professionally and identify opportunities for process improvement.
  • Utilize technology, tablets, and reporting systems to document and complete reviews.
  • Represent the organization professionally during all provider interactions.

Required Qualifications

  • Bachelor's Degree required.
  • Valid driver's license with an acceptable driving record.
  • Current automobile insurance.
  • Willingness and ability to travel extensively throughout Ohio.
  • Experience using tablets/iPads and Microsoft Office applications.
  • Strong written communication, documentation, and dictation skills.
  • Excellent organizational, time management, and analytical skills.
  • Demonstrated ability to work independently with minimal supervision.
  • Professional demeanor with strong interpersonal, listening, and communication skills.

Preferred Experience

Minimum of two (2) years of experience in one or more of the following areas:

  • Public Health
  • Critical Care
  • Home Health
  • Long-Term Care (LTC)
  • Behavioral Health or Mental Health Services
  • Developmental Disabilities Services
  • Children's Services
  • Elder Care Services
  • Community Social Services

In addition, experience in one or more of the following is preferred:

  • Medicaid programs
  • Provider monitoring or auditing
  • Compliance reviews
  • Third-party billing
  • Provider training and education
  • Healthcare operations
  • Quality assurance

What We're Looking For

  • Honest, dependable, and self-motivated.
  • Comfortable working independently in the field.
  • Detail-oriented with strong investigative and observational skills.
  • Skilled at analyzing information and making objective recommendations.
  • Able to maintain professionalism while navigating challenging situations.
  • Customer-focused with excellent problem-solving abilities.

Benefits Through Staffing Solutions Organization (SSO)

  • Medical Insurance
  • Dental Insurance
  • Vision Insurance
  • 401(k) with Employer Match
  • Paid Time Off (PTO)
  • Paid Holidays
  • Flexible Spending Accounts (FSA)
  • Employee Assistance Program (EAP)
  • Additional Employee Perks