Healthcare Case Manager - Remote

Fortuna BMCNewington, CT
Remote

About The Position

Join a high-impact team supporting U.S. Veterans through the Medical Disability Examination (MDE) program. In this role, you will help ensure timely and accurate coordination of medical examinations that directly support Veterans' Compensation & Pension (C&P) claims with the Department of Veterans Affairs. You will work in a fast-paced, metrics-driven environment where organization, communication, attention to detail, and professionalism are critical to success. This fully remote opportunity is ideal for individuals who thrive in structured operational environments and are passionate about delivering exceptional service while supporting an important mission. Beyond day-to-day case ownership, this role offers the opportunity to take on leadership and operational support responsibilities that contribute directly to team success and overall program performance. Case Managers may assist with mentoring newer team members, supporting workflow coordination, sharing critical operational updates, and helping drive consistency across the department. Individuals in this role are expected to exercise sound judgment, navigate complex situations, and collaborate effectively with both internal teams and external stakeholders. This position also plays an important role in supporting training, development, and continuous improvement initiatives within the Case Management team. High-performing individuals may contribute to onboarding support, knowledge sharing, coaching, and identifying opportunities to improve productivity, quality, and timeliness. The ideal candidate is someone who not only performs well independently but also contributes positively to team development, operational excellence, and the overall success of the MDE program.

Requirements

  • Associate degree required
  • Strong verbal and written communication skills with the ability to interact professionally with Veterans, clinic staff, and internal teams
  • Experience using Electronic Health Records (EHR) systems and the Microsoft Office Suite
  • Ability to multitask, prioritize competing deadlines, and maintain exceptional attention to detail
  • Ability to work independently in a remote environment while also collaborating effectively within a team structure
  • Comfortable working in a performance-based environment with defined KPIs and operational expectations
  • Reliable high-speed internet connection and a secure, distraction-free remote workspace
  • Required US Citizenship and US residence

Nice To Haves

  • Minimum of 1–2 years of experience in a healthcare, medical scheduling, call center, claims processing, case management, or related operational environment preferred
  • Experience reviewing medical documentation, coordinating appointments, or managing complex workflows is strongly preferred

Responsibilities

  • Review Examination Scheduling Requests (ESRs), medical records, and service records to determine case readiness and required examinations and/or diagnostic testing
  • Submit and track clarification requests with the Department of Veterans Affairs (VA) and manage cases through completion
  • Coordinate with claimants, clinic staff, and internal stakeholders to schedule appointments, monitor exam completion, and ensure required documentation is submitted accurately and timely
  • Maintain detailed case documentation while navigating sensitive information with professionalism and discretion
  • Collaborate across operational teams and clinic partners to resolve issues, escalate concerns appropriately, and support efficient case processing
  • Serve as a point of contact (POC) for assigned clinics when applicable, ensuring effective communication and coordination
  • Support operational workflows, mentor team members when needed, and contribute to process improvement initiatives
  • Meet productivity, quality, timeliness, and performance metrics within a highly structured, metrics-driven environment
  • Adapt to evolving technologies, tools, AI, and automation systems utilized within the program

Benefits

  • Paid sick leave based on state regulations after 90 days of employment
  • Medical, dental, and vision coverage after a waiting period (60% paid by Fortuna)
  • Free TeleMedicine and Mental Health support for all employees and their families
  • Additional voluntary benefits: Group Life Insurance, Accidental Insurance, Critical Care, Short-Term Disability
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