Medical Case Manager — Case Adjudication Support & Member Services

Program: HQ AFRC/SG Aeromedical Case Management Support (RFQ FA664326Q0004)

Location: HQ AFRC, Robins AFB, Warner Robins, GA (on-site)

Employment type: Full-time, non-exempt (SCA) - contingent on award

Labor category
Medical Record Technician (Medical Case Manager)

Reports to Lead Medical Case Manager / Focal Point (UHP)

Essential Healthcare Solutions is supporting Unified Health Partners. This role processes high-volume aeromedical cases for HQ AFRC with a primary focus on preparing cases for provider adjudication, compiling final dispositions, and serving as the unit/member help desk. You confirm case files are complete and that provider statements match the case type and higher-level (e.g., PEB) requirements, compile final disposition packages and member mail-outs, and answer day-to-day questions from medical personnel across the force.

You are cross-trained on all team functions and rotate to cover intake and data entry during surge.

• Confirm all required data is included in case files for HQ AFRC provider adjudication; confirm provider statements match the case type and higher-level (e.g., PEB) requirements.
• Reference and apply general medical guidelines and standards used to adjudicate cases; obtain medical opinions/recommendations from professional medical personnel.
• Collect and compile data for final case disposition and member mail-out (~702 final disposition/mail-out actions per month).
• Provide day-to-day advice and assistance to medical personnel across 69 units and three numbered Air Forces; receive calls and return messages within 2 duty days.
• Communicate effectively with coworkers, leaders, commanders, first sergeants, MAJCOMs, and AFMEDCOM, and help resolve conflicts at different levels.
• Screen and route incoming/outgoing correspondence, materials, publications, regulations, and directives; expedite items needing government attention.
• Assist with disposition of LOD determinations and RILOs where applicable.
• Cross-cover intake, data entry, and system-of-record updates (AIMWTS, ECT, PEPP, MEDXS) as directed to balance workload.

• Domain experience:
  Demonstrated experience processing and managing physical exams and medical standards - acquired through a military medical environment (e.g., USAF Physical Exam Standards / PES, aeromedical, or reserve medical unit) OR an equivalent civilian aeromedical, occupational health, or disability evaluation system (DES) environment.
• Regulatory knowledge:
  Working knowledge of medical standards for retention, flying classes, Line of Duty (LOD) determinations, and special operational duty for the USAF; familiarity with the Aeromedical Waiver Guide (AMWG) and the Medical Standards Directory (MSD), applicable AFI and 422/469 and DES processes (or the ability to rapidly acquire it).
• Medical literacy:
  Basic knowledge of anatomy, physiology, disorders of human body systems, and emergency medical care procedures; proficiency with medical terminology and ICD-10 coding, used accurately when documenting cases.
• Communication & administrative skills:
  Excellent oral and written communication; ability to translate complex medical/administrative instructions to service members at their comprehension level; project-management / workflow-tracking ability.
• Technical skills:
  Proficiency with Adobe PDF and Microsoft Office (Word, Excel, Outlook, PowerPoint); proficient typing on both QWERTY and 9-key/numeric pads.
• Baseline requirements:
  Able to work independently with strong time-management and prioritization skills; exceptional customer-service skills; fluent in reading, writing, speaking, and understanding English.
• Customer-facing strength:
  Strong interpersonal and de-escalation skills for a high-touch help-desk…