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Onsite Reviewer - Ohio

Department: PCG Health
Location: Columbus, OH

Onsite Reviewer - Ohio Program

Company Overview:

Public Consulting Group, Inc. (PCG) is a $285 million, fast growing for profit company providing management consulting and technology services to help public sector education, health, human services, and other government clients achieve their performance goals and better serve populations in need. Founded in 1986 and headquartered in Boston, Massachusetts, PCG has more than 1,600 professionals in 47 offices throughout the U.S, in Montreal, Canada, London, England and Lodz, Poland. The firm draws on more than two decades of consulting to public sector clients in all 50 states, Canada and the EU to deliver best-practice solutions and measurable results to state and local public agencies, state-operated facilities, and private providers that do business with government agencies. PCG is committed to a diverse workforce which is a reflection of our clients and the people they serve. Our organizational culture attracts and rewards people who are results-oriented and interested in making an immediate impact on their community as well as their own career. 

Scope of Program:

The overarching responsibility for this position is to ensure Medicaid providers are providing legitimate services, and are operating within the required Ohio administrative code rules by completing site visits at the providers listed service location(s). Reviewer will operate on a solo basis and travel daily to various provider locations across Ohio, but primarily working the Columbus/ Cincinnati area. Overnight stays at hotels are at times required, based on reviewerís location for a given week.

Ohio Program Onsite Reviewer Job Duties:

  •  Travel daily to various provider site locations.
  •  Conduct site visits at various locations across Ohio.
  •  Execute the site visit checklist and ask questions of the provider in accordance to protocol.
  •  Ability to thoroughly document the site visit with correct grammar and punctuation; documentation must convey a story of the site visit experience.
  •  Document the result of site visit according to protocol, and work in accordance with the QA department by meeting all deadlines.
  •  Make a recommendation based on the information gathered during the site visit whether to enroll, or continue enrollment for the provider. 
  •  Maintain confidentiality at all times, regarding provider/site visit information.
  •  Meet work standards (e.g. productivity, quality, and customer-service standards).
  •  Work as a solo reviewer and be able to self-manage deadlines and timelines.
  •  Resolve provider concerns and identify work process improvements.
  •  Ensure compliance with the Ohio Department of Medicaid by analyzing provider practices and protocols by examining documentation practices of the provider.
  •  Must exhibit excellent technical skills. 
  •  A professional appearance and personable with excellent listening and communication skills. 

Onsite Reviewer Skills and Qualifications:

  •  Required skills or licenses include; Bachelorís degree, iPad/ tablet experience, dictation skills, Microsoft office skills, good sense of direction, valid driverís license, good driving record and auto insurance certificate.
  •  Two yearís plus provider experience with any one or all of the following: public health, critical care, children, elderly, developmentally disabled; One -year provider monitoring, Medicaid or 3rd party billing, or provider training; One year in home health, public institution, LTC program, Mental Health or community social services. 
  •  Excellent time management and organizational skills.
  •  Honest, reliable, self-motivated and able to work independently without direct supervision.

All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity, marital status, age, national origin, protected veteran status, or disability. VEVRAA Federal Contractor.  

Staffing Solutions Organization LLC is an e-Verify participant.

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