Medical Case Manager -- Case Adjudication Support & Member Services

Job Description

Job Description

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 toLead Medical Case Manager / Focal Point (UHP)

POSITION SUMMARY

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.

KEY RESPONSIBILITIES

•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; escalate 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.

REQUIRED QUALIFICATIONS

•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 AFIs, 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 role; ability to communicate medical/administrative instructions clearly to members and units.

SYSTEMS YOU'LL USE (GOVERNMENT-PROVIDED ACCESS & TRAINING )

The Government furnishes access to all systems of record, the government-configured computer/network you will use, and system-specific training. You do not need to own, license, or bring these systems — access is granted after your Tier 1 background investigation clears. You must be proficient in, or able to rapidly acquire proficiency in:

•AIMWTS — Aeromedical Information Management Waiver Tracking System (waiver case documentation and routing).

•ECT — Electronic Case Tracking (AFRC case-management workflow / system of record).

•PEPP — Physical Examination Processing Program (exam ordering, processing, and closeout).

•MEDXS — Air Force medical readiness applications portal.

•JLV — Joint Longitudinal Viewer (read-only DoD/VA/community medical record viewer).

•MICT — Management Internal Control Toolset (self-assessment / compliance checklists).

•PHA — Periodic Health Assessment programs; plus Microsoft Office (Word, Excel, Outlook, PowerPoint) and Adobe PDF.

PREFERRED / HIGHLY DESIRED

•In-depth knowledge of Line of Duty (LOD) determinations and Medical Evaluation Board (MEB) processes.

•Prior hands-on experience in a USAF/AFRC/ARC aeromedical or reserve medical unit, or with the specific systems above (AIMWTS, ECT, PEPP) — clears the System-Experience gate with proof rather than crosswalk.

CLEARANCE & ONBOARDING REQUIREMENTS

•U.S. person / background investigation: Must be able to obtain and maintain a favorable Tier 1 (T1) National Agency Check with Inquiries (NACI). Tier 1 certification is required within 30 days of contract start; no network or system access is granted without a valid T1 or approved interim access. (Investigation cost is covered by the employer, not the candidate.)

•Non-Disclosure Agreement: Must sign the AFRC/SG Non-Disclosure Agreement prior to beginning performance.

•Required training: Must complete DoD Cyber Awareness, HIPAA, Privacy Act, and Derivative Classification training (government-provided).

WORK ENVIRONMENT & CONDITIONS

•Location: On-site at HQ Air Force Reserve Command, Robins Air Force Base (Warner Robins), GA. Single site; travel is not required. Relocation and travel are not reimbursed.

•Schedule : Full-time, normally 8 hours/day between 0800–1600 ET, Monday–Friday (core hours 0900–1500 ET), excluding federal holidays and Air Force Family/Down Days. Overtime is not authorized; flex-time is permitted to meet performance requirements.

•Telework: Situational telework only, with prior COR approval, using a government-approved VPN; sensitive data may not be stored on local/unapproved devices.

• Non-personal services: This is a non-personal services contract. You are an employee of the contractor, take direction from and are supervised by the contractor (not the Government), and will identify yourself as contractor personnel at all times.

• Compensation: Covered by the Service Contract Act, Wage Determination 2015-4495, labor category 12190 (Medical Record Technician). Base pay $21.48/hr (SCA minimum). Health & Welfare $5.55/hr. Non-exempt.