Complex Case Manager III

Medica•,

1d•$72,100 - $123,600•Remote

About The Position

Medica's RN Case Managers provide a member-centric, evidence-based model of care across multiple products. The Case Management program is designed to support members with the highest needs, helping members navigate the complexities of the healthcare system and ensuring safe transitions between care settings. Through individualized assessments, case managers identify each member’s goals of care, coordinate services across various settings, and connect members with community resources that align with their needs. This holistic approach enables case managers to reduce the burden of illness for both individuals and their families while contributing to lower overall healthcare costs.

Requirements

Associate's or Bachelor's degree in Nursing
5+ years of clinical/acute care experience beyond degree
Current, unrestricted RN license in the state of residence

Nice To Haves

Certified Case Manager (CCM) preferred, or ability and commitment to obtain within two years of hire
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.
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).
Sound clinical foundation and familiarity with chronic conditions, ADLs/IADLs, and social determinants of health.
Excels in communication with physicians and health care providers.
Excellent internal and external customer service skills.
Strong analytical 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 daily.