Case Manager III

Medica•,

3h•$72,100 - $123,600•Remote

About The Position

Medica is a nonprofit health plan serving over a million members across multiple states. We focus on delivering personalized healthcare experiences and collaborating with providers to ensure members receive excellent care. Our team values accountability, data-driven decisions, continuous learning, and collaboration. The RN Case Managers at Medica utilize a member-centered, evidence-based model of care across various products. The Case Management program is designed to facilitate smooth and safe transitions for members between different care settings. This role involves assessing individual care goals, coordinating medical and supportive services, and connecting members with community resources to meet their needs and objectives. The ultimate goal is to reduce the burden of illness for individuals and their families while also decreasing healthcare costs.

Requirements

Associate’s or Bachelor’s degree in Nursing
5+ years of clinical/acute care experience
Current, unrestricted RN license in the state of residence
Certified Case Manager (CCM) preferred, or ability and commitment to obtain within two years of hire required
Eligibility to work in the US: Medica does not offer work visa sponsorship for this role. All candidates must be legally authorized to work in the United States at the time of application. Employment is contingent on verification of identity and eligibility to work in the United States.

Nice To Haves

Experience working with vulnerable and complex populations in a clinical, home care or telephonic environment; direct case management experience strongly preferred.
Experience and at ease working with various populations: multiple age groups, ethnic and socioeconomic backgrounds, medical, surgical backgrounds and a generalized level of understanding across specialty care areas.
Experience managing multiple computer systems and tools including Microsoft Products and medical documentation platforms.
Professional demeanor: Engaging, persistent and assertive. Empathetic, pragmatic, and prescriptive.
General working knowledge of how various health care services link together (the health care continuum).
Excels in communication with physicians and health care providers.
Excellent internal and external customer service skills.
Strong decision-making skills.
Ability to think creatively and be comfortable taking the lead in negotiating and accessing resources.
Ability to have positive impact on team by modeling and supporting change.
Understand, articulate and support the organization’s mission, vision, goals and strategy.
Work efficiently towards department benchmarks.
Excellent verbal and written skills and the ability to present in a group setting.
Ability to work positively in a fluid, ever-changing environment.
Ability to thrive in a fast-paced setting, make decisions under stress, and manage multiple complex issues on a daily basis.

Responsibilities

Assessing individual care goals
Coordinating medical and supportive services
Connecting members with community resources to support their needs and objectives
Performs other duties as assigned