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Medica · 1 day ago

Complex Case Manager III

United States

Full-time

Remote

Senior Level

$72K/yr - $98K/yr

5+ years exp

Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. The RN Case Manager will provide a member-centric model of care, conducting assessments and coordinating services to support members with high needs.

Health CareMedical

No H1B

Responsibilities

Provide a member-centric, evidence-based model of care across multiple products

Conduct comprehensive assessments, developing, implementing, and monitoring individualized care plans

Coordinate services across the healthcare continuum

Reduce the illness burden for individuals and their families while decreasing healthcare costs

Perform other duties assigned

Qualification

RN licenseCertified Case ManagerElectronic health recordsClinical nursing experienceManaged care knowledgeCustomer service skillsCommunication skillsDecision-making skillsTeam collaborationAdaptability

Required

Bachelor'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

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

Preferred

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