Case Management Specialist Lead

About the job

Inova Fairfax Hospital is seeking a Case Management Specialist Lead. This position will be full-time, Monday-Friday 40 Hours each week.

*Inova is consistently ranked a national healthcare leader in safety, quality and patient experience. We are also proud to be consistently recognized as a top employer in both the D.C. metro area and the nation. *

Featured Benefits:

• Committed to Team Member Health: offering medical, dental and vision coverage, and a robust team member wellness program.
• Retirement: Inova matches the first 5% of eligible contributions – starting on your first day.
• Tuition and Student Loan Assistance: offering up to $5,250 per year in education assistance and up to $10,000 for student loans.
• Mental Health Support: offering all Inova team members, their spouses/partners, and their children 25 mental health coaching or therapy sessions, per person, per year, at no cost.
• Work/Life Balance: offering paid time off, paid parental leave, and flexible work schedules

The Case Management Specialist Lead schedules and supervises CMS workflow. Administers and monitors financial and revenue management programs for the Case Management department, such as department invoice and billing management. Coordinates CMS staff, and performs a wide variety of administrative activities to support the Case Management department. Responsible for advanced administrative duties including: payroll, department staff scheduling, and department education. Responsible for training CMS together with monitoring performance for accuracy and quality outcomes. Has oversight responsibility for timely service arrangements including Home Health, Durable Medical Equipment, Ambulance/Transport, Housing, Skilled Nursing Facility and others in order to ensure that appropriate continuing care services are in place for patient transitions. Responsible for ensuring that CMS staff accomplish delivery of regulatory forms such as the mandated Observation letter, and the Medicare IMM notifications. Monitors, interprets, and communicates payor requirements to case managers, social workers, patients and, physicians. Responsible for training, and supporting new, and established CMS team members. Maintains and updates staff/team records. Supports the case management outcome model through clinical, clerical and support services to assist with the planning, assessment and implementation of appropriate patient transitions and participates in the annual and ongoing budget processes.

Job Responsibilities:

• Maintains oversight of CMS team.
• Responsible for CMS scheduling and work-flow assignments.
• Responsible for training and continuing education for CMS team.
• Ensures CMA completes timely service arrangements for discharge planning/continuing care.
• Responsible for department scheduling with department leader.
• Addresses and solves provider and payor issues quickly with support from Case Management leader staff.
• Assigns and monitors CMS completion and delivery of mandated Observation and Medicare letters as directed.
• Monitors monthly outcome data to improve CMA team performance in conjunction with Department Leader.
• Accurately communicates financial and clinical information to clinicians, patients, families, care team members and external customers. Accurately documents, as evidenced through chart review.
• Completes state and federal forms related to patient level of care, according to regulatory standards, in order to assist with patient transition.
• Maintains all accounts receivable/payable functions for the department to ensure timely payments. Maintains and monitors the system Case Management program including reimbursement of all negotiated vendor contracts.
• Reviews and approves time/attendance for department staff on a biweekly basis. Performs periodic reviews to track employee time and attendance for department leadership. Submits any identified time/pay adjustments to Payroll in a timely manner.
• Maintains records of all system Case Management files and acts as liaison to Foundation, auxiliary and external vendors.
• Assists in monitoring the operational budget, in collaboration with department Director, related to funds disbursement and reconciliation.
• Performs other duties as assigned.

Requirements:

• Requires a High School Diploma or GED
• Three years of relevant professional experience

Preferred Qualifications:

• Previous Case Management Specialist experience preferred.

About Us

We are Inova, Northern Virginia’s leading nonprofit healthcare provider. Every day, our 26,000+ team members provide world-class healthcare to the communities we serve. Our people are the reason we're a national leader in healthcare safety, quality and patient experience. And from best-in-class facilities to professional development opportunities, we support them at every step. At Inova, we're constantly striving to be ever better — to shape a more compassionate future for healthcare.

Inova Health is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to age, color, disability, gender identity or expression, marital status, national or ethnic origin, political affiliation, pregnancy (including childbirth, pregnancy-related conditions and lactation), race, religion, sex, sexual orientation, veteran status, genetic information, or any other characteristics protected by law.

Additional Information

• Job Identification: 692384
• Job Category: Administrative Services
• Posting Date: 2026-11-15
• Apply Before: 2026-11-16
• Job Schedule: Full time
• Salary Range: $24.17 - $39.40
• Pay Rate Frequency: HOURLY