[Hiring] TOC Case Manager III @Medica

Role Description

Medica’s RN Case Managers provide a member-centered, evidence-based model of care across multiple products. Our Case Management program is responsible for ensuring a smooth and safe transition for members between various care settings. This role involves:

• Assessing individual care goals
• Coordinating medical and supportive services
• Connecting members with community resources to support their needs and objectives

The case manager will be responsible for ensuring a safe transition by:

• Conducting discharge assessments
• Medication reconciliation
• Reviewing warning signs and symptoms
• Ensuring follow-up appointments are scheduled and attended

These actions enable the case manager to reduce the illness burden for individuals and their families while decreasing healthcare costs.

Qualifications

• Associate’s or Bachelor’s degree in Nursing
• 3+ years of clinical/acute care experience

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 required

Preferred Qualifications

• 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 including Microsoft Products and medical documentation platforms
• 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 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, vision
• PTO
• 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.