[Hiring] Pregnancy Case Manager III @Medica

Role Description

Medica’s Pregnancy RN Case Managers provide a member-centered, evidence-based model of care across multiple products. Our Pregnancy Case Management program aims to serve maternal members with the highest needs and help them navigate the health system with the aim of healthy birth outcomes. The Pregnancy Program focuses on improving maternal and infant health outcomes by delivering education, care coordination, identifying gaps in care, and advocacy.

• Conduct comprehensive assessments.
• Develop, implement, and monitor individualized care plans.
• Coordinate services across the healthcare continuum.
• Reduce the risk of pregnancy and birth-related complications for individuals and their families.
• Decrease healthcare costs.

Qualifications

• Associate or bachelor’s degree in nursing.
• 3+ years of clinical/acute care experience including direct maternal patient care.

Requirements

• 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.
• Experience working with the pregnancy population in a clinical or home care setting; direct case management experience strongly preferred.
• Experience and comfort working with various populations: multiple age groups, ethnic and socioeconomic 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 in maternal health, with expertise in pregnancy care, management of common complications (e.g., preeclampsia, gestational diabetes, preterm labor), and support for postpartum recovery, including physical and mental health considerations.
• NICU and pediatric experience preferred but not required.
• 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 a positive impact on the 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.
• Generous total rewards package.

Company Description

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.