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…
Skills: Case Management, Clinical Assessment, Care Coordination, Patient Advocacy, Medical Documentation
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…
Skills: Data Mining, Report Development, Statistical Analysis, Predictive Modeling, Microsoft Excel
Customer Service Representative - Commercial Products (8/31 Start Date)
United States · Remote Solely
$33k–$41k/yr
Mid level
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…
Skills: Customer Service, Verbal Communication, Written Communication, Multi-tasking, Time Management
Customer Service Representative - Government Products (8/31 Start Date)
United States · Remote Solely
$33k–$41k/yr
Mid level
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…
Skills: Customer Service, Healthcare Knowledge, Verbal Communication, Written Communication, Multi-tasking
Customer Service Representative - Government Products (8/31 Start Date)
United States · Remote Solely
$33k–$41k/yr
Mid level
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…
Skills: Customer Service, Healthcare Knowledge, Verbal Communication, Written Communication, Multi-tasking
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…
Care Coordinator II or III RN or Licensed SW (All Counties in MN)
Minnetonka, Minnesota, United States · Remote OK
$63k–$108k/yr
Senior
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…
Skills: Case Management, Care Planning, Clinical Documentation, Interpersonal Skills, Problem Solving
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…
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 …
Skills: Financial Analysis, Financial Reporting, Forecasting, Budgeting, MS Excel
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…
Skills: Strategic Finance, Capital Allocation, Financial Modeling, ROI Analysis, Business Case Development
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…
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…
Skills: GAAP, Statutory Reporting, Financial Statements, Month-end Close, Microsoft Excel
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…
Skills: Medical Necessity Review, Case Management, Appeals Decision Making, Utilization Management, Clinical Policy Development
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…
Skills: Medical Record Retrieval, HIPAA Compliance, EHR Platforms, Data Validation, Record Indexing
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…
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…
Skills: Financial Modeling, Provider Reimbursement Analysis, SQL, Power BI, Tableau
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…
Compliance Program Consultant, Mental Health Parity
Minnetonka, Minnesota, United States · Hybrid
$79k–$118k/yr
Senior
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…
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…
Skills: Lean Six Sigma, Project Management, Organizational Change Management, Kaizen Facilitation, Business Process Management
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…
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$72k–$124k/yr
Full-time
associate degree, bachelor degree
Medical, Dental, Vision, PTO, Holidays, Paid volunteer time off
Posted 28d ago
~40 hrs/week
Remote in Arizona, United States, Arkansas, United States, Florida, United States, Georgia, United States
Responsibilities
The Case Manager III provides member-centered, evidence-based care to ensure safe transitions between care settings. Responsibilities include assessing care goals, coordinating medical services, and connecting members with community resources to reduce illness burden and costs.
Requirements
Requires an Associate's or Bachelor's degree in Nursing, a current RN license, and at least 5 years of clinical or acute care experience. A Certified Case Manager (CCM) certification is preferred or must be obtained within two years of hire.
Full job 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.
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, and connecting members with community resources to support their needs and objectives. Performs other duties as assigned.
These actions enable the case manager to reduce the illness burden for individuals and their families while decreasing healthcare costs.
Required Qualifications
Associate’s or Bachelor’s degree in Nursing
5+ years of clinical/acute care experience
Required Certifications/Licensure
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 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.
This position is a Remote role. To be eligible for consideration, candidates must have a primary home address located within any state where Medica is registered as an employer - AR, AZ, FL, GA, IA, IL, KS, KY, MI, MN, MO, ND, NE, OK, SD, TN, TX, VA, WI
The full salary grade for this position is $72,100 - $123,600. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $72,100 - $97,850. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data. In addition to compensation, Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees.
The compensation and benefits information is provided as of the date of this posting. Medica’s compensation and benefits are subject to change at any time, with or without notice, subject to applicable law.
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.
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.
Related keywords
RN LicenseCertified Case ManagerCCMAcute CareHealthcare ContinuumTelephonic Case ManagementHome CareEvidence-Based CareMedical Documentation PlatformsPatient TransitionsNonprofit Health PlanComplex Populations
To better your life with care in the moments that matter.
Industry
Insurance
Company size
1,001-5,000 employees
Founded
1975
Headquarters
Minnetonka, MN
LinkedIn followers
45,847
🔹At Medica, we are a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, North and South Dakota and beyond-- we invest back into these communities and are proud of our longstanding relationships built over time there.
🔹Medica's Community Giving Initiatives prioritizes support for early childhood and maternal health programs, food security, and mental health needs.
🔹We have invested millions of dollars and hundreds of volunteer hours to help our non-profit community partners.
🔹In 2021, we formed a joint venture with SSM Health, and through that invested in Dean Health Plan.
🔹Medica and Dean Health Plan, both mission-driven health plans, have significant similarities in our histories, operations, cultures, and deep community commitment.
🔹Our new relationship is driven by technology, a mission driven vision, and innovation.
🔹Together we have an even greater opportunity to support the health care needs of members and patients, and to further enhance our provider relationships.
🔹For more information about Medica, click here: https://www.medica.com/our-story
Offices: 401 Carlson Parkway, Minnetonka, MN 55305, US · 301 Carlson Parkway, Minnetonka, MN 55305, US · 1277 Deming Way, Madison, Wisconsin 53717, US
Health InsuranceHealth PlansMedicareMedicaidHMOand Health PlansHealth CareMedical
To better your life with care in the moments that matter.
Industry
Insurance
Company size
1,001-5,000 employees
Founded
1975
Headquarters
Minnetonka, MN
LinkedIn followers
45,847
🔹At Medica, we are a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, North and South Dakota and beyond-- we invest back into these communities and are proud of our longstanding relationships built over time there.
🔹Medica's Community Giving Initiatives prioritizes support for early childhood and maternal health programs, food security, and mental health needs.
🔹We have invested millions of dollars and hundreds of volunteer hours to help our non-profit community partners.
🔹In 2021, we formed a joint venture with SSM Health, and through that invested in Dean Health Plan.
🔹Medica and Dean Health Plan, both mission-driven health plans, have significant similarities in our histories, operations, cultures, and deep community commitment.
🔹Our new relationship is driven by technology, a mission driven vision, and innovation.
🔹Together we have an even greater opportunity to support the health care needs of members and patients, and to further enhance our provider relationships.
🔹For more information about Medica, click here: https://www.medica.com/our-story
Offices: 401 Carlson Parkway, Minnetonka, MN 55305, US · 301 Carlson Parkway, Minnetonka, MN 55305, US · 1277 Deming Way, Madison, Wisconsin 53717, US
Health InsuranceHealth PlansMedicareMedicaidHMOand Health PlansHealth CareMedical