Case Manager III

Medica

. Provide member-centric, evidence-based case management across multiple programs and products .

Posted 10/12/2026full-timeRemote • United StatesMid-LevelSenior💰 $72,100 - $123,600 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in case management, including care coordination and member engagement, while effectively utilizing clinical documentation platforms and understanding Medicare and Medicaid programs. Strong ability to communicate complex medical information clearly and support diverse populations through resource identification and collaboration.

Highest-signal resume keywords

Registered Nurse (RN) LicenseCertified Case Manager (CCM)Experience in Acute Care or Community-Based CareKnowledge of Medicare and Medicaid ProgramsStrong Clinical and Documentation Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Case ManagementCare CoordinationHealth Risk Assessment (HRA)EHR/Clinical Documentation PlatformMedical/Surgical BackgroundResource IdentificationCare Plan DevelopmentKnowledge of Healthcare ContinuumMotivational InterviewingActive Listening

Soft Skills

Excellent Communication SkillsInterpersonal SkillsNegotiation SkillsAbility to Simplify Medical LanguageAdaptability in Fast-Paced Environment

Certifications & Qualifications

Registered Nurse (RN) LicenseCertified Case Manager (CCM)

Industry Keywords

North Dakota MedicaidCommunity-Based OrganizationsVulnerable PopulationsSocial Determinants of HealthHealthcare Services

About the role

Key responsibilities & impact

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

What you’ll need

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

Comp & perks

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