[Hiring] Complex Case Manager III @Medica

Role Description

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.
• Conducting comprehensive assessments.
• Developing, implementing, and monitoring individualized care plans.
• Coordinating services across the healthcare continuum.
• Reducing the illness burden for individuals and their families while decreasing healthcare costs.
• Performing other duties as assigned.

Qualifications

• 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.

Requirements

• 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.

Skills & Abilities

• 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.

Benefits

• Competitive medical, dental, and vision plans.
• PTO and Holidays.
• Paid volunteer time off.
• 401K contributions.
• Caregiver services.
• Many other benefits to support our employees.

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.

Equal Opportunity Employer

We are an Equal Opportunity employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.