Site Inspector - Remote Wisconsin

Gainwell Technologies LLC•Any city, OH

80d•$54,300 - $77,500•Remote

About The Position

The Site Inspector conducts provider site visits and program integrity reviews in support of Wisconsin Medicaid provider enrollment and revalidation requirements. Working closely with the Wisconsin Department of Health Services (DHS) Office of Inspector General (OIG), the role verifies provider operational readiness, validates compliance with CMS requirements, and supports efforts to prevent fraud, waste, and abuse in the Medicaid program. The position includes scheduling and conducting inspections, documenting findings, researching provider information, and preparing legally defensible documentation related to enrollment actions and compliance reviews. This is a field-based position requiring frequent travel throughout Wisconsin. It involves direct interaction with healthcare providers and collaboration with Wisconsin DHS OIG and Gainwell program integrity and provider enrollment teams. The work is performed independently and requires strong time management, scheduling, documentation, and case management skills.

Requirements

Two or more years of experience in inspections, auditing, investigations, compliance, healthcare operations, provider relations, program integrity, fraud prevention, or a related field.
Experience researching, reviewing documentation, gathering information, and preparing detailed written reports while maintaining accuracy and confidentiality.
Strong analytical, organizational, problem-solving, and communication skills.
Ability to work independently and manage multiple priorities.
Proficiency with Microsoft Office applications, documentation systems, databases, virtual meeting platforms, and technology used to support field-based work.

Nice To Haves

Experience with Medicaid, Medicare, healthcare providers, provider enrollment, regulatory compliance, program integrity, or government-sponsored healthcare programs.

Responsibilities

Conduct onsite provider inspections to verify operational status, physical location, business signage, and ability to perform services identified in enrollment applications.
Coordinate and schedule provider site visits, including communications, appointment management, and use of virtual meeting technology when appropriate.
Capture photographs, complete inspection templates, document findings, and upload supporting materials into designated systems according to established procedures.
Conduct enrollment program integrity compliance reviews, including research, analysis, and evaluation of provider information to identify potential compliance concerns.
Prepare detailed reports, recommendations, and supporting documentation for enrollment determinations, sanctions, terminations, denials, and administrative review processes.