RN Case Manager – Military & Family Support Services

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Maximus

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10.000+ Mitarbeiter

🏛️ Regierung

🏥 Gesundheitswesen

💼 Beratung

💰 €7.926.732 Post-IPO Equity - Maximus im 2010-12

Government • Healthcare • Consulting

Maximus ist ein Unternehmen für Dienstleistungen im öffentlichen Sektor, das mit Regierungsbehörden zusammenarbeitet, um Programme in den Bereichen Gesundheit, Soziale Dienste, Verteidigung, nationale Sicherheit und zivile Behörden zu modernisieren und zu betreiben. Das Unternehmen kombiniert Technologie (KI, Analytik, Cloud, Cybersicherheit), Omnichannel-Kontaktzentren und Systeme für Berechtigung/Anmeldung, klinische und Medicaid-Unternehmensdienstleistungen sowie Beratungs- und Programmdienstleistungen, um die Bürgererfahrung und die Programmergebnisse zu verbessern. Unterstützt durch jahrzehntelange Erfahrung und Skalierung im Regierungsbereich, unterstützt Maximus Bundes-, Landes- und lokale Kunden mit menschorientierter betrieblichen Unterstützung und umfassender digitaler Modernisierung.

Beschreibung

• Coordinate patient care and documentation pathways for service members and their families • Serve as a liaison between military and civilian medical and non-medical agencies • Conduct assessments, care planning, and evaluation to promote optimal health • Support successful transitions back to duty or into the civilian community • Review favorable and partially favorable determinations according to applicable regulations • Render medical necessity determinations for assigned Medicare State East cases • Resolve technical issues within assigned Medicare reconsideration cases • Review cases, summarize facts, and assess issues involved • Perform special projects such as legal or medical research, drafting proposal sections, or serving as a project liaison • Act as the project Subject Matter Expert (SME) • Perform other duties assigned by management

🎯 Anforderungen

• Active RN license • Minimum two-year nursing degree from an accredited institution • Bachelor's degree with 5–7 years of experience consulting within the designated function • Minimum 2 years of nursing and/or case management experience • Advanced degree preferred • Case manager certification from a recognized certifying organization, or ability to obtain certification within one year of hire • Active Secret clearance at minimum • Ability to develop solutions to highly complex problems with ingenuity and innovation • Ability to ensure solutions align with organizational objectives • Ability to develop advanced concepts, techniques, and standards • Ability to develop new applications based on professional principles and theories • Demonstrated expertise in the field • Knowledge of diagnoses, client education principles, and management of complex medical, psychosocial, and financial problems • Knowledge of VA/DoW Clinical Practice Guidelines • Knowledge of healthcare financial environments and population-health fiscal stewardship • Research skills for evaluating practices, opportunities, and outcomes • Knowledge of pharmaceuticals, including effects, side effects, and complications • Knowledge of community resources, client entitlements, and benefit eligibility • Ability to use utilization-review criteria and identify quality and risk-management issues • Proficiency with information systems, technology, computers, and software applications for data collection, tracking, trending, analysis, and presentations • Professional oral and written communication skills • Team coordination, facilitation, and communication skills • Reliable high-speed internet service • Minimum 20 Mbps download speed, or 50 Mbps for shared internet connectivity • Minimum 5 Mbps upload speed • Master's degree in Social Work (MSW) preferred • Licensed Clinical Social Worker (LCSW) licensure preferred

🏖️ Vorteile

• Flexibility and work/life balance support • Medical, Dental, Vision, and Prescription plans • Partially funded HSA • Life Insurance • Auto, Home, Renters, and Pet Insurance discounts • 401(k) Retirement Savings Plan with Company Match • PTO • Paid holidays • Extended sick leave • Short and Long Term Disability coverage • Employee Assistance Program (EAP) • Employee recognition platform • Tuition Reimbursement • Employee discounts and perks • Wellness programs and resources • Training programs, workshops, conferences, and ongoing learning opportunities • Licensure and Certification Support, including renewal costs for required licenses and certifications • Company-issued computer equipment