TOC Case Manager III
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Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in case management, including conducting assessments, coordinating care, and connecting members with resources. Holds a current RN license and possesses strong decision-making and communication skills to effectively support diverse populations.
Highest-signal resume keywords
Registered Nurse (RN) LicenseCertified Case Manager (CCM)Clinical Case Management ExperienceMedication ReconciliationExperience with Vulnerable Populations
About the role
Key responsibilities & impact- Provide member-centered, evidence-based case management across multiple health plan products
- Ensure smooth and safe transitions between care settings
- Assess individual care goals
- Coordinate medical and supportive services
- Connect members with community resources
- Conduct discharge assessments
- Perform medication reconciliation
- Review warning signs and symptoms
- Ensure follow-up appointments are scheduled and attended
- Reduce illness burden for members and families while decreasing healthcare costs
Requirements
What you’ll need- Associate’s or Bachelor’s degree in Nursing
- 3+ years of clinical/acute care experience
- 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 required
- Experience working with vulnerable and complex populations in a clinical, home care, or telephonic environment preferred
- Direct case management experience strongly preferred
- Experience with multiple age groups and diverse medical, surgical, ethnic, and socioeconomic populations
- Experience managing multiple computer systems and tools, including Microsoft products and medical documentation platforms
- Working knowledge of how health care services link across the health care continuum
- Ability to communicate effectively with physicians and health care providers
- Strong decision-making skills
- Ability to negotiate and access resources creatively
- Ability to support organizational change
- Ability to understand, articulate, and support the organization’s mission, vision, goals, and strategy
- Ability to work efficiently toward department benchmarks
- Excellent verbal and written skills and 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
- 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 benefits
- Paid time off (PTO)
- Holidays
- Paid volunteer time off
- 401(k) contributions
- Caregiver services
- Other total rewards benefits
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Case ManagementMedication ReconciliationDischarge AssessmentsCare CoordinationClinical ExperienceHealth Care Continuum KnowledgeAssessment of Care GoalsManaging Multiple Computer SystemsScheduling Follow-Up AppointmentsUnderstanding of Health Plan Products
Soft Skills
Effective CommunicationStrong Decision-Making SkillsNegotiation SkillsAbility to Support Organizational ChangeAbility to Thrive in Fast-Paced Environments
Tools & Technologies
Microsoft ProductsMedical Documentation Platforms
Certifications & Qualifications
Registered Nurse (RN) LicenseCertified Case Manager (CCM) Preferred
Industry Keywords
Evidence-Based Case ManagementVulnerable PopulationsAcute CareHome CareTelephonic Environment