Case Manager III

🔥 0 minutes ago

🌵 Arizona, Florida, +15 more states – Remote

🌵 Arizona – Remote 🐊 Florida – Remote 🌽 Illinois – Remote 🌾 Iowa – Remote 🌪️ Kansas – Remote 🐎 Kentucky – Remote 🌾 Nebraska – Remote 🌾 North Dakota – Remote 🌪️ Oklahoma – Remote 🚗 Michigan – Remote ❄️ Minnesota – Remote 🏰 Missouri – Remote 🗿 South Dakota – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote ⚔️ Virginia – Remote 🧀 Wisconsin – Remote

💵 $72.1k - $123.6k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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Medica

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1975

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Medica is a nonprofit health plan and insurer with over 50 years of experience that provides individual & family plans, Medicare, Medicaid, and employer-provided health plans. It offers member services and tools for finding providers, managing benefits and claims, wellness programs, and community-focused initiatives through the Medica Foundation to advance health equity.

📋 Description

• Provide member-centric, evidence-based case management across multiple programs and products • Telephonically serve members by understanding individual goals of care • Coordinate care across the healthcare continuum • Assist members with accessing care and services • Provide education and manage medical case management interventions • Collaborate with members' established care teams • Support social determinants of health through resource identification and collaboration with appropriate agencies • Ensure all North Dakota DSNP members are supported by a case manager • Engage members or caregivers in annual Health Risk Assessments as required by CMS • Collaborate on and develop care plans based on individual needs identified in the HRA • Drive outcomes through comprehensive plans of care • Support care transitions within required timelines • Perform other duties as assigned

🎯 Requirements

• Associate's or Bachelor's degree in Nursing • 5+ years of experience in an acute care, home care, or community-based care setting • Experience utilizing an EHR/clinical documentation platform • Experience working with multiple age groups, vulnerable and complex populations, and diverse ethnic and socioeconomic backgrounds, including seniors and individuals with disabilities • Current, unrestricted RN license in the state of residence • Certified Case Manager (CCM) preferred, or ability to obtain within two years of hire • Strong knowledge of Medicare and Medicaid programs, specifically North Dakota Medicaid • Experience with and knowledge of community-based organizations and resources in North Dakota • Experience with health plans and case management • Medical/surgical background and generalized understanding across specialty care areas • Strong clinical and documentation skills • Knowledge of the healthcare continuum and linked healthcare services • Excellent interpersonal, verbal, and written communication skills • Ability to simplify medical language for individuals with limited medical knowledge • Ability to use motivational interviewing and active listening skills • Ability to negotiate and access resources • Ability to work toward department benchmarks and in a fast-paced, changing environment • Must be legally authorized to work in the United States at the time of application • Medica does not offer work visa sponsorship for this role

🏖️ Benefits

• Competitive medical, dental, and vision coverage • PTO • Holidays • Paid volunteer time off • 401K contributions • Caregiver services • Other total rewards benefits