About This Role
This role involves conducting thorough and professional investigations into various complaints and incidents, ensuring compliance with regulatory requirements and established timeframes. The investigator will also provide administrative and audit support to quality-focused departments.
Responsibilities
- Conduct investigations, reports, and reviews using approved investigative techniques and medical record review skills, including Abuse/Neglect reports, OSIG complaints, Human Rights complaints, incident management reviews, and dCLV reports
- Ensure investigations are conducted thoroughly, professionally, and within established regulatory, policy, and time frame requirements
- Accurately interpret and apply state and federal regulations
- Conduct interviews and gather relevant information
- Navigate electronic health records to locate and abstract necessary documentation
- Analyze findings to reach accurate conclusions
- Prepare organized, comprehensive investigative reports
- Maintain strict confidentiality
- Assist with facility-wide investigation tracking
- Coordinate with external entities including law enforcement, dCLV, DSS, APS, HR, OSIG, and OHR
- Complete related administrative duties
- Complete required DBHDS facility investigator training and maintain good standing as an investigator
- Provide administrative, reporting, statistical, and audit support to departments under the Chief Quality Officer, primarily Compliance, Health Information Management (HIM), and Utilization Review (UR)
- Support the Compliance Director with designated reports
- Complete HIM statistical reporting
- Provide court coverage as needed
- Conduct UR and other audits as assigned
- Cross-train to provide coverage for designated quality functions
- Perform other duties as assigned
Requirements
- Knowledge of effective investigative skills and abilities including interview skills and information gathering techniques
- Ability to effectively relate with a variety of individuals both internally and externally
- Ability to collect, interpret, and present data
- Ability to write clearly and concisely in an organized manner
- Working knowledge of state and federal policies and procedures
- Ability to interpret documentation in medical records
- Ability and skill in use of computer software including the electronic health record
- Ability to work independently and organize time effectively
- Knowledge of customer service principles
- Ability to objectively formulate logical, reasonable conclusions and recommendations