RN Case Manager – Military & Family Support Services

Maximus

RN Case Manager coordinating healthcare and continuity of care for service members and families at Maximus. Reviewing Medicare cases, assessing medical necessity, and supporting transitions back to duty or civilian life.

Posted 8/5/2026full-timeRemote • 🇺🇸 United StatesMid-LevelSenior💰 $73,950 - $105,850 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in patient care coordination, case management, and healthcare regulations, with a strong focus on optimizing health outcomes for service members and their families. Proficient in utilizing information systems for data analysis and effective communication across military and civilian medical agencies.

Highest-signal resume keywords

Active RN LicenseCase Manager CertificationKnowledge of VA/DoW Clinical Practice GuidelinesMinimum 2 Years of Nursing ExperienceProficiency with Information Systems

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Patient Care CoordinationCare PlanningMedical Necessity DeterminationComplex Problem SolvingResearch SkillsUtilization-Review CriteriaKnowledge of PharmaceuticalsHealthcare Financial EnvironmentsClient Education PrinciplesAssessment and Evaluation

Soft Skills

Professional Communication SkillsTeam CoordinationFacilitation SkillsIngenuity and InnovationProject Liaison Skills

Tools & Technologies

Information SystemsData Collection SoftwareTracking and Trending ApplicationsPresentation Software

Certifications & Qualifications

Case Manager CertificationLicensed Clinical Social Worker (LCSW) Licensure

Industry Keywords

Military Medical AgenciesCivilian Medical AgenciesPopulation-Health Fiscal StewardshipClient EntitlementsBenefit EligibilityHealthcare Regulations

About the role

Key responsibilities & impact

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

Requirements

What you’ll need

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

Benefits

Comp & perks

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