Case Manager III

This is a fully remote position, open to applicants in Arizona, +16 more states.

📋 Description

• Deliver member-focused, evidence-informed case management across various programs and products

• Provide telephonic support to members by understanding their unique care goals

• Coordinate care throughout the healthcare continuum

• Assist members in accessing necessary care and services

• Educate and manage interventions related to medical case management

• Collaborate with established care teams of members

• Address social determinants of health by identifying resources and working with relevant agencies

• Ensure that all North Dakota DSNP members have access to a case manager

• Involve members or caregivers in the annual Health Risk Assessments as mandated by CMS

• Collaborate on and create care plans tailored to the individual needs identified in the HRA

• Achieve outcomes through comprehensive care plans

• Facilitate care transitions within required timelines

• Perform additional duties as assigned

⛳️ Requirements

• Associate's or Bachelor's degree in Nursing

• Over 5 years of experience in acute care, home care, or community-based care environments

• Proficiency in using an EHR/clinical documentation platform

• Experience working with a variety of age groups, including vulnerable and complex populations, and diverse ethnic and socioeconomic backgrounds, such as seniors and individuals with disabilities

• Current, unrestricted RN license in the state of residence

• Certified Case Manager (CCM) preferred, or willingness to obtain certification within two years of hire

• Strong understanding of Medicare and Medicaid programs, particularly North Dakota Medicaid

• Familiarity with community-based organizations and resources in North Dakota

• Experience with health plans and case management

• Medical/surgical background with a general understanding across specialty care areas

• Strong clinical and documentation abilities

• Knowledge of the healthcare continuum and associated healthcare services

• Excellent interpersonal, verbal, and written communication skills

• Ability to convey medical terminology in simple terms for individuals with limited medical knowledge

• Proficiency in motivational interviewing and active listening techniques

• Capability to negotiate and access necessary resources

• Ability to work towards departmental benchmarks in a fast-paced and evolving environment

• Must be legally authorized to work in the United States at the time of application

• Medica does not provide work visa sponsorship for this position

🏝️ Benefits

• Competitive medical, dental, and vision insurance

• Paid time off (PTO)

• Holidays

• Paid volunteer time off

• 401K contributions

• Caregiver services

• Additional total rewards benefits