Note: The job is a remote job and is open to candidates in USA. Medica is a nonprofit health plan serving communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. They are seeking a Complex Case Manager III to provide personalized care and support to members with high needs, ensuring they navigate the healthcare system effectively.

Responsibilities

Provide a member-centric, evidence-based model of care across multiple products
Support members with the highest needs, helping members navigate the complexities of the healthcare system and ensuring safe transitions between care settings
Identify each member’s goals of care, coordinate services across various settings, and connect members with community resources that align with their needs

Skills

Associate's or Bachelor's degree in Nursing
5+ years of clinical/acute care experience beyond degree
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 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
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 and familiarity with chronic conditions, ADLs/IADLs, and social determinants of health
Excels in communication with physicians and health care providers
Excellent internal and external customer service skills
Strong analytical 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 daily

Benefits

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

Company Overview

Medica is a company that provides health coverage to meet customers needs for health plan. It was founded in 1975, and is headquartered in Minnetonka, Minnesota, USA, with a workforce of 1001-5000 employees. Its website is https://www.medica.com.

Medica

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[Remote] Complex Case Manager III