RN Case Manager

Medica

1d • Remote

About The Position

Medica is a nonprofit health plan with more than a million members that serves
communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We deliver
personalized health care experiences and partner closely with providers to
ensure members are genuinely cared for.

We're a team that owns our work with accountability, makes data-driven
decisions, embraces continuous learning, and celebrates collaboration — because
success is a team sport. It's our mission to be there in the moments that matter
most for our members and employees. Join us in creating a community of connected
care, where coordinated, quality service is the norm and every member feels
valued.

Medica’s RN Case Managers provide a member-centric, evidence-based model of care
across multiple products. Our Case Management program aims to serve the members
with highest needs and help them navigate the health system. This position
involves collaboration with members and their families, caregivers, providers,
and interdisciplinary teams to deliver holistic care. The case manager will be
responsible for conducting comprehensive assessments, developing, implementing,
and monitoring individualized care plans, and coordinating services across the
healthcare continuum. These actions enable the case manager to reduce the
illness burden for individuals and their families while decreasing healthcare
costs. RN degree required. Perform other duties assigned.

Requirements

• Associate's degree in Nursing or equivalent work experience in related field, plus 5 years of work experience beyond degree of clinical/acute care nursing
• Current, unrestricted RN license in the state of residence
• 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

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, including multiple age groups, ethnic and socioeconomic backgrounds provided in a clinical, home care or telephonic environment; direct case management experience strongly preferred
• Knowledge of managed care principles and regulatory guidelines preferred
• Proficiency in electronic health records and care management software

Responsibilities

• conducting comprehensive assessments
• developing, implementing, and monitoring individualized care plans
• coordinating services across the healthcare continuum
• Perform other duties assigned

Benefits

• competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree