Senior Case Manager

Clearance Level Must Currently Possess:

Clearance Level Must Be Able to Obtain:

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Job Description:

HRSA works to advance health equity and strengthen health systems that serve geographically isolated, economically challenged, or medically vulnerable populations. Through programs such as the OPTN, Ryan White HIV/AIDS Program, and community health initiatives, HRSA ensures access to high-quality services and fosters a skilled health workforce.

As part of GDIT’s people‑centric environment, the Senior Case Manager plays a critical leadership role in safeguarding patient safety, ensuring compliance with transplant policies, and strengthening national organ donation and transplantation processes. This role serves as a subject matter expert and senior advisor across the full lifecycle of case management activities—including case intake, triage, analysis, review, enforcement, and resolution.

The Senior Case Manager provides strategic oversight, mentors a team of case managers and investigators, drives continuous quality improvement, and collaborates closely with HRSA, OPTN Committees, CMS, and member organizations. This position ensures consistent, rigorous evaluation of case issues and helps shape national standards for organ allocation, member compliance, and patient safety.

• Provide advanced leadership, coaching, and performance direction for case managers and investigators responsible for patient safety and compliance case reviews.
• Oversee the workflow, prioritization, and quality of case management activities to ensure timely, consistent adherence to program standards.
• Develop and deliver training programs to strengthen team capabilities and ensure alignment with evolving OPTN policies and federal regulations.
• Serve as the senior escalation point for complex, sensitive, or high‑risk compliance matters.

• Lead strategic planning for case intake, triage, tracking systems, and review methodologies to enhance efficiency and transparency.
• Oversee secure management, redaction, and documentation of sensitive case information, ensuring complete compliance with federal privacy and security standards.
• Ensure case tracking tools and systems support real-time monitoring, stakeholder visibility, and data-driven analysis.
• Develop executive-level reports summarizing case trends, compliance risks, outcomes, and systemic insights for HRSA, OPTN Committees, and senior leadership.

• Conduct or oversee complex case assessments, including identifying severity, urgency, and required investigative pathways.
• Lead the development of comprehensive case review plans addressing timelines, data needs, and involved stakeholder groups.
• Coordinate external reviews and escalations, including engagement with CMS or other oversight bodies.
• Ensure fair, well-documented, consistent evaluations of case issues across diverse OPTN member institutions.

• Analyze case data to identify trends, systemic risks, and recurring patterns of non-compliance across transplant hospitals, OPOs, and histocompatibility labs.
• Provide strategic insights and recommendations that inform policy refinements, member education initiatives, and operational improvements.
• Lead continuous improvement initiatives to strengthen case intake, triage, investigation, and resolution processes.
• Evaluate historical case patterns and previous operational findings to inform proactive policy or process enhancements.
• Oversee the implementation of final recommendations, including monitoring corrective action plans and ensuring accurate documentation in OPTN systems.

• Represent GDIT and the case management function in high-level meetings, cross-functional workgroups, and task forces.
• Serve as a trusted advisor to HRSA, OPTN Committees, and partner organizations on matters related to compliance, patient safety, and policy implications.
• Facilitate communication and coordination across internal and external teams to ensure integrated, transparent case management practices.

• 8+ years of experience in compliance, investigations, quality improvement, auditing, or project management in healthcare or regulatory environments.
• Bachelor’s degree required; advanced degree preferred.
• Demonstrated expertise in federal, state, and local regulatory frameworks related to healthcare compliance.
• Must have experience analyzing clinical and program-level health data to advise senior management and government agencies on operations, regulatory compliance, patient safety, and program impact; deliver written findings and recommendations for process improvement.
• Prepare and present comprehensive program reviews to organizational leadership, including recommendations on policy modifications.
• Must have experience providing services on regulatory compliance and patient safety to government agencies, interpreting and applying OPTN policies.
• Strong analytical, risk assessment, and independent judgment capabilities.
• Exceptional written and verbal communication skills, including experience preparing executive-level reports.
• Proven leadership experience managing teams, mentoring staff, and driving organizational improvements.
• Outstanding organizational and project management skills.
• Demonstrated ability to manage sensitive information with discretion, confidentiality, and accuracy.
• Ability to travel up to 15% to member organizations nationwide.
• Ability to obtain and maintain a Public Trust clearance.

• Full-flex work week to own your priorities at work and at home.
• 401K with company match.
• Comprehensive health and wellness packages.
• Internal mobility team dedicated to helping you own your career.
• Professional growth opportunities including paid education and certifications.
• Cutting-edge technology you can learn from.
• Rest and recharge with paid vacation and holidays.

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