Case Manager

Role Overview

• Provide leadership and oversight for Site Visit Leads/Investigators during patient safety and compliance case reviews
• Act as the team lead for the task team responsible for managing case intake, triage, tracking, review, and resolution activities
• Train, motivate, and mentor team members to ensure high-quality case management activities and adherence to project deadlines and standards
• Manage the secure intake and documentation process for incoming patient safety and compliance cases from all sources
• Redact sensitive information and ensure proper record management in accordance with federal regulations
• Safeguard case records using secure storage, transfer, and handling methods
• Develop and maintain case tracking tools that monitor case progression, metrics, and outcomes from intake through resolution
• Ensure case tracking systems support real-time access for stakeholders and facilitate trend analysis
• Prepare regular and ad hoc reports summarizing case activity, resolution status, and outcomes for HRSA, OPTN Committees, and other stakeholders
• Assess newly submitted cases for severity, urgency, and scope
• Develop initial case review plans, including timeframes, required data, and identification of involved stakeholders
• Escalate cases when appropriate, including coordinating external reviews with entities like Centers for Medicare & Medicaid Services (CMS)
• Coordinate case-related activities among various stakeholder groups, including HRSA, OPTN Committees, and other contractors
• Document the roles, responsibilities, and coordination needs of all parties involved in individual cases
• Analyze case data to identify trends, patterns of non-compliance, and patient safety risks
• Prepare actionable recommendations for process improvement, policy updates, and educational initiatives for OPTN member organizations
• Provide insights to HRSA and other stakeholders on compliance issues, risks, and necessary corrective actions
• Conduct thorough, well-documented case reviews ensuring fair and consistent evaluation of patient safety and compliance issues
• Draft comprehensive final case reports summarizing findings, decisions, and recommended follow-up actions such as Corrective Action Plans (CAPs)
• Oversee the implementation of final decisions and recommendations, including tracking follow-up actions, updates to member records, and any necessary coordination with OPTN IT contractors or other teams
• Manage continuous quality improvement efforts to strengthen case intake, triage, review, and resolution processes
• Evaluate historical case trends and past operational reviews to refine workflows and policies proactively
• Recommend strategies for improving oversight and accountability in OPTN member compliance activities

Requirements

• Requires at least 6 years in compliance, project management, quality improvement, auditing, or investigations, within healthcare or regulatory environments
• A Bachelor's degree
• Strong understanding of federal, state, and local regulations
• Analytic skills: ability to use independent judgment to determine risk
• Excellent communication skills written and verbal
• Leadership capabilities
• Strong organizational skills to manage schedules and audit logistics
• Demonstrated ability to handle sensitive information securely and discretely
• Ability to travel to member organizations throughout the country (up to 15% of the time)

Benefits

• Comprehensive benefits and wellness packages
• 401K with company match
• Competitive pay and paid time off
• Full-flex work week to own your priorities at work and at home
• Paid Family Leave program providing up to 160 hours of paid leave in a rolling 12 month period for eligible employees
• 15 days of paid leave and additional 10 paid holidays per year