Case Manager

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Brain Injury Services (BIS) seeks a full‑time Brain Injury Case Manager to serve our clients. We are seeking case managers with a strong background in case management and at least two years of experience. Preferences will be given to candidates who have experience navigating Medicaid referrals, submitting service authorizations, monitoring billing, and collaborating with Managed Care Organizations (MCOs) in the Targeted Case Management (TCM) services for BIS clients.

Prince William County and surrounding areas.

Under the supervision of the Senior Manager of Case Management Services, the Case Manager provides community‑based case management to adults and children with acquired brain injury and their families in the Northern Virginia region. The adult brain injury program includes long‑term case management services and public awareness. These services are provided using a community‑based case management model.

This position requires a professional level of intervention with complex cases. The Case Manager position assumes the ability to work independently and exercise autonomy. The Department Manager may designate other duties. This position is guided by the mission of this organization to support individuals with brain injuries and their families in reaching their maximal level of functioning within their communities using a person‑centered approach.

• Adhere to professional standards, federal and local requirements, and MCO regulations to serve and protect the agency.
• Obtain information and make referrals for appropriate services, including TCM‑related referrals and general referrals to community services.
• Do a comprehensive intake evaluation, including completing all documentation designated in the Policy and Procedure Manual, and obtaining all necessary medical records from outside sources to ensure a thorough review and service eligibility.
• Complete all required paperwork for Medicaid TCM services, including service authorizations, assessments, evaluation, review, billing, and reporting.
• Complete a thorough client assessment, which includes the client’s strengths and weaknesses, family and community support systems, a needs assessment that covers all areas described in the Adult Brain Injury Case Management Policy and Procedure Manual, and the assessment of existing resources presently utilized by the client and gaps in services requiring intervention within 45 days of opening a case.
• Obtain appropriate releases, understand the laws regarding confidentiality, and uphold these laws.
• Provide education and awareness to the public on prevention, identifying children and adolescents with brain injury, and the support needed to transition students back to school successfully, and children back into their home community.
• Travel and provide services in clients’ homes and communities, including participation in discharge‑planning teams at children’s facilities and rehabilitation centers nearby.
• Determine when the maximal level of functioning has been achieved and outside services, such as life skills training/tutoring, need to fade.
• Complete all paperwork as described in the Policy and Procedure Manual and maintain charts orderly.
• Establish a solid therapeutic relationship with clients, their families, and community providers.
• Support clients in developing their own goals and plans and complete an Individualized Service Plan.
• Review the ISP every 90 days and adhere to the MCO’s rules and regulations about service review, ensuring client signatures for consent and participation.
• Identify, coordinate, and monitor goal‑directed community services to meet client needs and desired activities as outlined in their plans.
• Maintain in‑person and/or virtual contact with active clients and/or families at least monthly, with quarterly contact with follow‑along clients, offering support, guidance, and assistance in maximizing participation in the goal‑attainment process.
• Effectively negotiate for services in the client’s community.
• Maintain a…