Case Manager III

@ Medica

About the Role

Medica, a nonprofit health plan serving over a million members across multiple states, is seeking a Case Manager III to provide personalized health care experiences. In this remote role, you will assess member health, create and manage individualized care plans, and coordinate health services in a fast-paced, team-oriented environment.

Key Responsibilities

• Assess member health and develop tailored care plans.
• Coordinate and manage comprehensive health services.
• Engage with members, providers, and stakeholders effectively.
• Perform additional duties as assigned.

Required Qualifications & Certifications

Applicants must hold an Associate’s or Bachelor’s degree in Nursing and have 5+ years of clinical/acute care experience. A current, unrestricted RN license is required in the state of residence. Certified Case Manager (CCM) is preferred or must be obtained within two years of hire.

Preferred Experience & Skills

• Experience in transitional care and managing complex populations.
• Familiarity with multiple computer systems including Microsoft Products and medical documentation platforms.
• Excellent communication skills with providers and members.
• Ability to negotiate, make data-driven decisions, and thrive in a fluid environment.

Additional Information

This is a remote position open to candidates residing in states where Medica is registered as an employer. The salary grade for this role ranges from $70,700 to $121,200 annually, with a typical hiring range between $70,700 and $95,950. Medica offers a generous total rewards package including competitive benefits such as medical, dental, vision, PTO, holidays, volunteer time off, 401K contributions, and caregiver services.

Medica is an Equal Opportunity employer committed to workforce diversity. Eligibility to work in the U.S. is required; visa sponsorship is not offered.

Key skills/competency

• Care plan
• Coordination
• Clinical
• Communication
• Customer Service
• Decision-making
• RN license
• Documentation
• Negotiation
• Remote