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Medicaid Case Manager Jobs in Reston, VA (NOW HIRING)

Total Care Services, Inc.

Case Manager 1

Rockville, MD · Hybrid

$60K/yr

Case management or care coordination experience (waiver or Medicaid experience preferred) * Strong communication, organization, and documentation skills * Knowledge of Maryland community resources ...

MedStar Health

Field RN Case Manager

Washington, DC · On-site

$89K - $113K/yr

C. Case Management and conducts activities and functions required for this role. The Field RN ... Medicaid beneficiary support Medicaid for Nursing Home Placement Crime Victims Vocational ...

MedStar Health

Field RN Case Manager

Washington, DC · On-site

$88K - $112K/yr

C. Case Management and conducts activities and functions required for this role. The Field RN ... Medicaid beneficiary support Medicaid for Nursing Home Placement Crime Victims Vocational ...

Housing Up

PSH Case Manager Unit-Based

Washington, DC · On-site

$50K - $55K/yr

The case manager will also ensure that individual is linked to public benefits, such as Medicaid, SNAP, and TANF. Ultimately, these services are focused on ensuring that clients are empowered to ...

JSSA

Hospice - RN Case Manager

Rockville, MD · On-site

$90K/yr

Primary Nurse/Case Manager JSS Hospice is looking for a full time Primary Nurse/Case Manager to ... Have sufficient knowledge of third-party reimbursement, especially Medicare/Medicaid, to interpret ...

Medix

RN Case Manager

Washington, DC · On-site

$36.32 - $50/hr

Ideally have 2 years of Case Management experience ... Experience with Medicaid Members is preferred * Health plan experience is preferred * Pediatric ...

Moms in Motion

SF Case Manager Loudoun

VA · On-site

$45K - $60K/yr

Vision insurance Service Facilitator (SF) Case Manager MUST live in VA Daily local travel to client ... You'll spend your days connecting with families, helping them navigate Virginia's Medicaid Waiver ...

Moms in Motion

SF Case Manager Annandale

Annandale, VA · On-site

$20 - $25.50/hr

Vision insurance Service Facilitator (SF) Case Manager MUST live in VA Daily local travel to client ... You'll spend your days connecting with families, helping them navigate Virginia's Medicaid Waiver ...

Inova

Manager Case Management

Falls Church, VA · On-site

$21.25 - $27.50/hr

Inova Fairfax Hospital is looking for a dedicated Experienced Manager Case Management to join the ... and Medicaid Services (CMS), being named by IBM Watson Health as one the nation's highest ...

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All JobsMedicaid Case JobsMedicaid Case Manager JobsMedicaid Case Manager Jobs in Reston, VA

Medicaid Case Manager information

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How much do medicaid case manager jobs pay per hour?

As of Aug 10, 2026, the average hourly pay for medicaid case manager in Reston, VA is $23.88, according to ZipRecruiter salary data. Most workers in this role earn between $20.00 and $25.77 per hour, depending on experience, location, and employer.

How much do Medicaid case managers make?

Medicaid case managers typically earn between $40,000 and $65,000 annually, depending on experience, location, and employer. They often require knowledge of healthcare policies and case management software, with some positions offering additional benefits or certifications.

What qualifications do you need to be a Medicaid Case Manager?

To become a Medicaid Case Manager, candidates typically need a high school diploma or equivalent, with many roles requiring a bachelor's degree in social work, nursing, or a related field. Relevant experience in healthcare, social services, or case management, along with strong communication and organizational skills, is often required; some positions may also require certification in case management or Medicaid-specific training.

What is a Medicaid Case Manager?

Medicaid Case Managers are professionals who help individuals navigate the Medicaid system to ensure they receive appropriate healthcare services and benefits. They assess clients' needs, coordinate care plans, and connect them with medical providers, social services, and community resources. Their goal is to improve health outcomes by advocating for clients and helping them overcome barriers to care. Medicaid Case Managers often work with vulnerable populations, including the elderly, people with disabilities, and low-income families.

What are the key skills and qualifications needed to thrive as a Medicaid Case Manager, and why are they important?

To thrive as a Medicaid Case Manager, you need a background in social work, nursing, or a related field, along with strong knowledge of Medicaid policies and case management practices. Familiarity with case management software, electronic health records, and sometimes state-specific certification or licensure is typically required. Outstanding communication, problem-solving, and organizational skills help you effectively advocate for clients and coordinate care among various providers. These skills are essential for ensuring clients receive appropriate services, improving health outcomes, and maintaining compliance with Medicaid regulations.

What is the difference between Medicaid Case Manager vs Medical Social Worker?

AspectMedicaid Case ManagerMedical Social Worker
CredentialsTypically requires a bachelor’s degree in social work, healthcare, or related field; certification may be preferredRequires a master's degree in social work (MSW) and licensure
Work EnvironmentHealthcare facilities, community agencies, Medicaid programsHospitals, clinics, mental health facilities, community agencies
Employer & IndustryGovernment Medicaid agencies, healthcare providersHospitals, healthcare organizations, social service agencies

Medicaid Case Managers focus on coordinating Medicaid services and ensuring clients access benefits, often with a bachelor’s degree. Medical Social Workers provide broader psychosocial support, require a master's degree, and handle complex emotional and social issues. Both roles work in healthcare settings but differ in scope and qualifications.

What are some common challenges Medicaid Case Managers face when coordinating care for clients?

Medicaid Case Managers often navigate complex situations, such as balancing high caseloads, addressing diverse client needs, and overcoming barriers related to social determinants of health. They may encounter challenges in coordinating services across multiple providers and ensuring clients have access to the necessary resources. Effective communication, strong organizational skills, and adaptability are essential to manage these challenges and provide comprehensive support to clients. Team collaboration and ongoing professional development also help case managers stay updated on policy changes and best practices.
What are popular job titles related to Medicaid Case Manager jobs in Reston, VA? For Medicaid Case Manager jobs in Reston, VA, the most frequently searched job titles are:
What job categories do people searching Medicaid Case Manager jobs in Reston, VA look for? The top searched job categories for Medicaid Case Manager jobs in Reston, VA are:
What cities near Reston, VA are hiring for Medicaid Case Manager jobs? Cities near Reston, VA with the most Medicaid Case Manager job openings:
Medicaid Case Manager jobs near you
Infographic showing various Medicaid Case Manager job openings in Reston, VA as of August 2026, with employment types broken down into 1% As Needed, 83% Full Time, 15% Part Time, and 1% Contract. Highlights an 93% Physical, 3% Hybrid, and 4% Remote job distribution, with an average salary of $49,670 per year, or $23.9 per hour.

Case Manager (Fairfax/Loudoun)

Brain Injury Services

Fairfax, VA • On-site

$65K - $68K/yr

Full-time

Posted 15 days ago

Job description

Job Type
Full-time
Description
Brain Injury Services (BIS) seeks a full-time Brain Injury Case Manager to serve our clients. We are seeking case managers with a strong background in case management and at least 2 years of experience. Preferences will be given to candidates who have experience navigating Medicaid referrals, submitting service authorizations, monitoring billing, and collaborating with Managed Care Organizations (MCOs) in the Targeted Case Management (TCM) services for BIS clients.
Position Service area:
Fairfax County and Loudoun County
Definition:
Under the supervision of the Senior Manager of Case Management Services, the Case Manager provides community-based case management to adults and children with acquired brain injury and their families in the Northern Virginia region. The adult brain injury program includes long-term case management services and public awareness. These services are provided using a community-based case management model.
Distinguishing Characteristics:
This position requires a professional level of intervention with complex cases. The Case Manager position assumes the ability to work independently and exercise autonomy. The Department Manager may designate other duties. This position is guided by the mission of this organization to support individuals with brain injuries and their families in reaching their maximal level of functioning within their communities using a person-centered approach.
Essential Job Functions and Responsibilities:
  • Adhere to professional standards, federal and local requirements, and MCO regulations to serve and protect the agency.
  • Obtain information and make referrals for appropriate services, including TCM-related referrals and general referrals to community services.
  • Do a comprehensive intake evaluation, including completing all documentation designated in the Policy and Procedure Manual, and obtaining all necessary medical records from outside sources to ensure a thorough review and service eligibility.
  • Complete all required paperwork for Medicaid TCM services, including service authorizations, assessments, evaluation, review, billing, and reporting.
  • Complete a thorough client assessment, which includes the client's strengths and weaknesses, family and community support systems, a Needs assessment that covers all areas described in the Adult Brain Injury Case Management Policy and Procedure Manual, and the assessment of existing resources presently utilized by the client and gaps in service's requiring intervention within 45 days of opening a case.
  • Obtains appropriate releases, understands the laws regarding confidentiality, and upholds these laws.
  • Provide education and awareness to the public on prevention, identifying children and adolescents with brain injury, and the support needed to transition students back to school successfully, and children back into their home community.
  • Travel and provide services in clients' homes and communities. This includes participating in the discharge planning teams, when possible, at children's facilities and rehabilitation centers nearby (e.g., Cumberland Hospital in New Kent, Kluge Children's Rehab Center in Charlottesville, NRH's Pediatric Program in Washington, Kennedy-Krieger Institute in Baltimore).
  • Determine when the maximal level of functioning has been achieved and outside services, such as life skills training/tutoring, need to fade.
  • Completes all paperwork as described in the Policy and Procedure Manual and always maintains charts orderly.
  • Establish a solid therapeutic relationship with clients, their families, and their community providers.
  • Supports clients in developing their own goals and plans based on the needs assessment and utilizing various planning tools. Completes an Individualized Service Plan and provides a written copy to the client.
  • Review the ISP every 90 and adhere to the MCO's rules and regulations about service review. Clients' signatures are required to ensure the client's consent and participation in services.
  • Identify, coordinate, and monitor goal-directed community services to meet the client's needs and desired activities as outlined in their plans.
  • Maintain in-person and/or virtual contact with active clients and/or families at least monthly and quarterly contact with follow-along clients. Contact is made to offer support, and guidance, and assist them in maximizing the clients' participation in the goal-attainment process.
  • Effectively negotiate for services for clients in their communities professionally.
  • Travel and provide services in client's homes and communities
  • Maintain a confidential home environment equipped with a reliable internet connection to facilitate remote workdays; otherwise, working from the office will always be required.
  • Full-time staff should maintain a caseload of up to 30 active clients and no more than 15 follow-along clients. Full-time staff with reduced working hours (30, 32, 35 hrs/week) will carry a caseload of up to 26 active clients. Part-time staff (20 hrs or less) will have a caseload of up to 20 clients.
  • Understand the Vendor Contract budget and prioritize service payments based on need, financial eligibility, and resource availability.
  • Understand the Vendor Contract for the various MCOs and the different requirements of each
  • Provide education to clients, their families, and the community regarding brain injury and community resources.
  • Demonstrate a commitment to person-centered services and the opportunity for clients to choose their services and providers as documented in the individualized service plan and case notes.
  • Spend at least 50% of their time in direct contact with clients and their families, providing supportive counseling, coordination of services, resource determination, monitoring of services, and team meetings. This will be monitored through case documentation and Outlook calendar entries.
  • Professionally present themselves in dress, language, questions, and comments.
  • Maintain a routine schedule, which reflects a 40-hour week but is flexible to include evening meetings. This is also monitored through the Outlook Calendar entries
  • Participate in professional training, particularly in the brain injury field, and additional training as directed by the supervisor.
  • Attend and participate in all Case Management Department meetings, Staff Professional Trainings, staff meetings, and regular one-on-one supervision with the department manager
  • Other duties as directed by the Department Manager of Case Management Services.

Requirements
Knowledge, Skills, and Abilities:
• Integrity, discretion, and respect for confidentiality and privacy
• Good knowledge of Brain injury and its effects on individuals and families
• Self-directed, able to work independently with a high level of autonomy and strong problem-solving skills
• Knowledge of ADA and IDEA as well as special education
• knowledge of Long-Term Case Management
• Knowledge of the Veterans Affairs system
• Knowledge of the Medicaid system and MCOs
• Knowledge of supportive counseling techniques
• Knowledge of basic medical terminology
• Knowledge of community agencies/resources.
• Excellent oral and written communication skills and the ability to de-escalate misunderstanding errors in a professional manner
• Strong technology and computer skills, e.g., typing, computing, data entry, virtual video platforms (e.g., Zoom), DocuSign, and other technical skills as the job requires
• Strong assessment and analytical skills
• Ability to prioritize work under pressure
• Strong time management skills
• Strong organizational skills
• Strong attention to detail
• Strong spelling, math, and financial skills
• Strong documentation skills on time
Essential Job Requirements:
• Valid driver's license and reliable personal transportation to travel throughout Fairfax, Arlington, City of Alexandria, Loudoun, and Prince William areas. Local travel is required
• Act as the point of contact for TCM referrals
• Physical mobility
• Ability to perform math calculations
• Ability to perform complex problem-solving and reasoning.
• Ability to secure a telework environment at home that maintains confidentiality and professionalism
• Access to secure and reliable internet services at home for the remote work option
• Ability to shift between in-person and virtual service delivery models.
• Must be able to read, write, and proofread professionally.
Educational Requirements:
• Master's Degree in the human service field, e.g., Social Work, Rehab Counseling, Psychology, Occupational Therapy, etc.
• Brain Injury Fundamental Training and Qualified Brain Injury Specialist training are required upon hiring.
• Certified Brain Injury Specialist training is optional after 1 year of hiring.
Preferred:
Bilingual in any of the following languages: Spanish, Arabic, Korean, and Vietnamese
Salary Description
$65,000 - $68,000

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