Complex Case Manager Iii

Overview
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 are a team that owns our work with accountability, makes data-driven decisions, embraces continuous learning, and celebrates collaboration — because success is a team sport.
Our mission is 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-centric, evidence-based model of care across multiple products.
The Case Management program supports members with the highest needs, helping them navigate the complexities of the healthcare system and ensuring safe transitions between care settings.
Through individualized assessments, case managers identify each member's goals of care, coordinate services across settings, and connect members with community resources that align with their needs.
This holistic approach enables case managers to reduce the burden of illness for both individuals and their families while contributing to lower overall healthcare costs.
Performs other duties as assigned.
Responsibilities
Medica's RN Case Managers provide a member-centric, evidence-based model of care across multiple products.
The Case Management program is designed to support members with the highest needs, helping members navigate the complexities of the healthcare system and ensuring safe transitions between care settings.
Through individualized assessments, case managers identify each member's goals of care, coordinate services across various settings, and connect members with community resources that align with their needs.
This holistic approach enables case managers to reduce the burden of illness for both individuals and their families while contributing to lower overall healthcare costs.
Performs other duties as assigned.
Qualifications
Associate or Bachelor's degree in Nursing
5+ years of clinical/acute care experience
Required Certification / 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
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 ease working with various populations: multiple age groups, ethnic and socioeconomic backgrounds, medical and surgical backgrounds, and a general understanding across specialty care areas
Experience managing multiple computer systems and tools
Skills and Abilities
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 lead in negotiating and accessing resources
Ability to positively impact the team by modeling and supporting change
Understand, articulate and support the organization's mission, vision, goals and strategy
Work efficiently toward 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
Work Arrangement
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, MD, ME, MI, MN, MO, ND, NE, OK, SD, TN, TX, VA, WI.
Compensation & Benefits
The full salary grade for this position is $70,700 - $121,200.
While the full salary grade is provided, the typical hiring salary range is expected to be between $70,700 - $95,950.
Annual salary range placement depends on factors including education, work experience, applicable certifications and/or licensure, scope of responsibility, internal pay equity, and external market data.
In addition to compensation, Medica offers a generous total rewards package including medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits.
Notes on Compensation & Benefits
The compensation and benefits information is provided as of the date of this posting and may change at any time, subject to applicable law.
Equal Opportunity
We are an Equal Opportunity employer, where all qualified candidates receive consideration for employment regardless of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities.
This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights notice from the Department of Labor.
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