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.
