TOC Case Manager III

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

📋 Description

• Deliver member-focused, evidence-based case management across various health plan offerings.

• Facilitate seamless and secure transitions between different care environments.

• Evaluate individual care objectives.

• Organize medical and supportive services.

• Link members with community resources.

• Carry out discharge assessments.

• Conduct medication reconciliation.

• Monitor warning signs and symptoms.

• Ensure follow-up appointments are arranged and attended.

• Alleviate the burden of illness for members and their families while reducing healthcare expenses.

⛳️ Requirements

• Associate’s or Bachelor’s degree in Nursing required.

• A minimum of 3 years of clinical or acute care experience.

• Valid, unrestricted RN license in the state of residence.

• Certification as a Case Manager (CCM) preferred, or the ability and commitment to obtain it within two years of hire is required.

• Experience working with vulnerable and complex populations in clinical, home care, or telephonic settings preferred.

• Direct case management experience is highly preferred.

• Familiarity with various age groups and diverse medical, surgical, ethnic, and socioeconomic backgrounds.

• Proficient in managing multiple computer systems and tools, including Microsoft applications and medical documentation platforms.

• Understanding of how healthcare services connect across the continuum of care.

• Effective communication skills with physicians and healthcare providers.

• Strong decision-making abilities.

• Creative negotiation skills and resource accessibility.

• Capability to support organizational change.

• Ability to comprehend, articulate, and promote the organization’s mission, vision, goals, and strategy.

• Efficiently work towards departmental benchmarks.

• Exceptional verbal and written communication skills, with the ability to present in group settings.

• Positive attitude in a dynamic, ever-evolving environment.

• Ability to excel in a fast-paced setting, make decisions under pressure, and handle multiple complex issues daily.

• Must have legal authorization 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 observed.

• Paid time off for volunteering.

• 401(k) contributions.

• Caregiver support services.

• Additional total rewards benefits.