Case Manager

MaxHP is hiring a Case Manager who provides comprehensive coordination of services for service members and their families. This role coordinates patient care and documentation pathways, acting as a liaison between military and civilian medical and non-medical agencies to ensure continuity of care. Case Managers conduct assessments, planning, and evaluation of care, with the goal of achieving optimum health and facilitating a successful transition for service members back to duty or into the civilian community.

U.S. citizenship is required. Candidates must possess an active U.S. Government security clearance or be eligible to obtain and maintain a security clearance as required for contract performance.

This position is pending upon contract award.

Candidates should be able to support operations at one or more of the following locations: Tucson, AZ; Coronado, CA; Colorado Springs, CO; Washington, DC; Fort Walton Beach, FL; Homestead, FL; Tampa, FL; Valparaiso, FL; Columbus, GA; Honolulu, HI; Fayetteville, NC; Jacksonville, NC; Clovis, NM; Clarksville, TN; Virginia Beach, VA; Tacoma, WA; Stuttgart, Germany; Kadena, Japan; Pyeongtaek, South Korea; Mildenhall, United Kingdom.

At MaxHP, your expertise supports a mission that matters. As a joint venture between Maximus and Endurion, MaxHP brings together specialized capabilities and resources to support the POTFF Program, strengthening human performance, resilience, and mission readiness across the Special Operations community. Our professionals play an essential role in supporting the people behind the mission, helping Service members and their families remain strong, ready, and resilient. Here, your experience becomes part of something bigger: directly supporting those who serve at the highest levels of our Nation’s defense.

About the POTFF Program:

The Preservation of the Force and Family (POTFF) program supports U.S. Special Operations Forces (SOF) personnel and their families through an integrated, holistic approach to human performance, health, and readiness. The program brings together specialized professionals across physical, psychological, cognitive, social, and spiritual performance to strengthen resilience, optimize performance, and support long-term mission readiness and career longevity.

Essential Duties and Responsibilities:

• Provide a full range of professional health care principles, practices, and procedures in clinical settings or within the local unit, to analyze the full scope of problems associated with providing appropriate, cost-effective care to DoW beneficiaries.

• Collect, organize, record, and communicate data relevant to primary health assessments including detailed medical history to develop time sensitive treatment plans which delineate the expected process of care delivery for selected case managed clients or populations.

• Assess clients, using established protocols, to provide appropriate and cost-effective care.

• Establish priorities for client care, monitor and evaluate progress toward the stated goals to provide coordinated, efficient, effective health care.

• Oversee discharge-planning activities to ensure ideal timing and sequencing of client care.

• Provides professional assistance with health care resources to identify clients’ needs for referrals to appropriate health care providers or facilities.

• Negotiate, write, finalize, and administer product/service agreements to ensure mutual compliance in meeting care goals.

• May also serve as the central point and POTFF program lead for tracking and referring service members into cross-functional teams, and multi-domain services for a common problem set such as sleep, physical or mental injury. They will also be responsible for development, execution of multi-domain initiatives and will collect, analyze, and report their data to higher level authority as requested. Case Managers who are licensed as clinical social workers may provide counseling and other services consistent with the scope of their licenses and the clinical practice privileges have been granted by the cognizant medical treatment facilities.

• Seek feedback from peers, professional colleagues, clients, and outcomes research, to expand clinical knowledge, enhance role performance, and increase knowledge of professional issues. Effectively consult with health care providers at all levels and negotiate with outside providers for services and products to obtain client services and support. Adhere to local, state, and federal laws and regulations, professional code of ethics, and practice standards to ensure adherence within legal and professional parameters.

• Use pre-established utilization, review criteria, and recognize and report actual or potential quality and risk management issues to improve practice and ensure compliance.

• Use information systems and technology to manage individual or population health, continuously improve practice, and effectively communicate practice outcomes to involved stakeholders.

• Use computers and software applications to conduct data collection, tracking, trending, and analysis. An ability to design and present computer-generated outcome analysis information to provide timely, effective and higher-level educational programs or project briefings.

'- One of the following pathways is required; the pathway applicable to a billet is stated in the applicable Task Order:

• (a) Nursing pathway: an associate or higher degree in nursing from an accredited program and a current, full, active, and unrestricted registered-nurse license; OR

• (b) Social-work pathway: Master’s degree in social work from a graduate school fully accredited by the Council on Social Work Education (CSWE) and licensed at an independent level in social work (LCSW or equivalent).

The following 3 items are required:

• Demonstrate skill in understanding diagnoses to assist clients to optimize their level of function and self-care.

• Demonstrate knowledge of client education principles and management of complex medical, psychosocial, and financial problems to enhance client adherence to individualized treatment plans and train peers and staff.

• May be required to receive and maintain clinical practice privileges.

Required Minimum Experience and Skills:

• If qualifications meet the nursing pathway, then a minimum of three (3) years’ nursing experience or case management and be certified as a case manager by a recognized certifying organization, e.g., Commission for Case Manager Certification, American Case Management Association, or American Nurses Credentialing Center or shall obtain the certification within one (1) year of hiring.

• If qualifications meet the Social-work pathway, then a minimum of 500 hours of active practice in their discipline in each of the past three (3) years. Experience working in a government setting such as DoW or Department of Veterans Affairs (VA) MTF is preferable.

• Professional oral and written communication skills with peers, outside agencies, vendors, providers, and Military Health System (MHS) stakeholders to exchange information, provide briefings, presentations, research, and metrics to demonstrate or advance effective, efficient case management practice, outcomes, and organizational/MHS value.

• Skill in team coordination, facilitation, and communication to facilitate the exchange of information/ education, enhance goal achievement; augment abilities of client support network, and effect change in system or policy at any level.

• Knowledge and skills in the use of VA/DoW Clinical Practice Guidelines to ensure an evidence-based standardized process of care to military beneficiaries.

• Knowledge of the healthcare financial environment and the fiscal dimension of population health to ensure optimal stewardship of resources.

• Skill in the use of research tools to critically evaluate existing practices, opportunities, and outcomes.

• Knowledge of pharmaceuticals, their desired effects, side effects, and complications of their use to gauge their effect on clients and their recovery.

• Knowledge of community resources, client entitlement/benefit eligibility, and ability to access these resources to assist clients/families in optimizing their level of function and self- care.

• Knowledge of current third-party regulations and policies, with special emphasis on TRICARE and Medicare benefits and services, to identify alternative financing sources to which DoW beneficiaries may be entitled. Experience with TRICARE, Medicare, VA, or other third-party healthcare systems and benefit programs, including knowledge of eligibility requirements, covered services, reimbursement processes, and community healthcare resources.

Maximus is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.

Minimum Salary

$73,950

Maximum Salary

$105,850