Case Review Manager Quality

Job Description

Job Description

Who We Are: 

Veteran Benefits Guide was founded by a former United States Marine with the goal of ensuring that Veterans receive accurate disability benefits in a timely manner. Since it was founded, VBG has guided more than 55,000 Veterans through the complicated Veteran Affairs (VA) disability claims process. As a company founded by a Veteran and staffed by many Veterans and families of Veterans, VBG is committed to advocating for policies that protect the rights and interests of former service members. 

What We Are Looking For: 

We are seeking a Case Review Manager. Quality is responsible for the leadership, performance, and operational oversight of the Case Review Team. The Case Review Team reviews claim prior to submission to the Department of Veterans Affairs (VA) to help ensure quality, accuracy, consistency, and adherence to established requirements and standards.

This role is responsible for ensuring team quality, productivity, and timeliness expectations are achieved while providing technical leadership, coaching and developing team members, identifying quality and process improvement opportunities, and partnering cross-functionally to support continuous improvement.

The Case Review Manager, Quality translates quality findings, operational trends, and performance data into actionable recommendations that strengthen claim quality, operational performance, process consistency, and the Veteran experience.

The ideal candidate possesses strong knowledge of the VA disability claims process, excellent analytical and critical-thinking skills, demonstrated leadership experience, and the ability to effectively coach, develop, and guide a high-performing team in a fast-paced environment.

What You’ll Do:

· Lead and provide operational oversight of the Case Review Team.

· Manage team workload, capacity, priorities, and workflow to meet quality, productivity, and timeliness goals.

· Ensure Case Review activities follow VBG SOPs, policies, quality standards, and applicable VA requirements.

· Provide technical guidance and serve as an escalation point for complex cases and quality concerns.

· Monitor and analyze quality, productivity, timeliness, workload, and capacity metrics.

· Review audit findings and performance trends to identify risks, root causes, and improvement opportunities.

· Translate quality findings into coaching, training, corrective actions, and process improvements.

· Recruit, onboard, coach, develop, and evaluate team members.

· Identify training needs and support employee career development and succession planning.

· Partner with POD Managers and other leaders to address performance and behavioral concerns.

· Facilitate regular team meetings and communicate priorities, process changes, and organizational updates.

· Collaborate cross-functionally to identify root causes and implement solutions that improve quality and operational performance.

· Provide leadership with quality insights, trends, and actionable recommendations.

· Identify opportunities to improve the effectiveness, efficiency, consistency, and scalability of the Case Review function.

· Promote a culture of accountability, collaboration, continuous learning, and quality improvement.

· Perform other duties and responsibilities as assigned.

Qualifications

· Comprehensive knowledge of the VA disability claims process, including complex claims.

· Strong understanding of DBQs, RDLs, and claims-related medical terminology.

· Ability to analyze RDLs, identify potential errors, and provide guidance on complex claims.

· Demonstrated leadership experience, including coaching, mentoring, and managing employees.

· Strong analytical, critical-thinking, problem-solving, and attention-to-detail skills.

· Strong written and verbal communication skills.

· Ability to collaborate effectively across departments and organizational levels.

· Strong organization, time management, and prioritization skills.

· Ability to adapt to changing priorities and work effectively in a fast-paced environment.

· Proficiency with Microsoft Office and applicable business systems and technology.

Education and Experience

· High school diploma or equivalent required.

· Bachelor’s degree in Business Administration, Healthcare Administration, or related field preferred.

· Minimum 3 years of management experience.

· Experience in VA disability claims, Case Review, Quality, or a related function preferred.

· Experience with quality metrics, audits, performance management, and process improvement.

· Internal candidates must have a minimum of two years of tenure with VBG.

· Internal candidates must have been in their current role for at least six months.

· Strong understanding of VBG policies, procedures, systems, and practices is required.

Supervisory Responsibilities:

This position has responsibilities for the functional area team members and all additional assigned staff.

Position Type:

This is a full-time position with flexibility to work from home based on business needs. The days and hours of operation are Monday through Friday, 8:00 a.m. to 5:00 p.m. Schedules must be approved by the Senior Manager, Quality.

Where we are located:

This position is based in our Las Vegas office on E. Warm Springs Road. This is an in-office position.

EEO:

Veteran Benefits Guide provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, national origin, ancestry, physical disability, mental disability, medical condition, marital status, sex (including pregnancy, childbirth, breastfeeding or related medical conditions), gender (including gender identity and gender expression) genetic characteristic, sexual orientation, registered domestic partner status, age, military or veteran status, hairstyle or hair texture, reproductive health decision making, or any other characteristic protected by federal, state, or local laws.