Medica Health Plans

Pregnancy Case Manager III

Medica Health Plans • $72K — $97K *
US-AnywhereRemote in United States
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Associate or bachelor's degree in nursing
  • 3+ years of clinical/acute care experience including direct maternal patient care
  • Current, unrestricted RN license in the state of residence
  • Certified Case Manager (CCM) preferred, or ability to obtain within two years of hire
  • Experience working with pregnancy populations in clinical or home care settings.

Responsibilities

  • Conduct comprehensive assessments of maternal members
  • Develop, implement, and monitor individualized care plans
  • Coordinate services across the healthcare continuum
  • Educate members on maternal health and resources available
  • Advocate for members to ensure they receive necessary services.

Benefits

  • Competitive medical, dental, and vision plans
  • Paid time off and holidays
  • Paid volunteer time off
  • 401K contributions
  • Caregiver services support.
Full Job Description
Medica's Pregnancy RN Case Managers provide a member-centered, evidence-based model of care across multiple products. Our Pregnancy Case Management program aims to serve maternal members with the highest needs and help them navigate the health system with the aim of healthy birth outcomes. The Pregnancy Program focuses on improving maternal and infant health outcomes by delivering education, care coordination, identifying gaps in care, and advocacy.

The case manager will be responsible for conducting comprehensive assessments, developing, implementing, and monitoring individualized care plans, and coordinating services across the healthcare continuum. These actions enable the case manager to reduce the risk of pregnancy and birth related complications for individuals and their families while decreasing healthcare costs.

Minimum Qualifications

  • Associate or bachelor's degree in nursing
  • 3+ years of clinical/acute care experience including direct maternal patient care


Licensure/Certification

  • 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


Skills and Abilities

  • Experience working with the pregnancy population in a clinical or home care setting; direct case management experience strongly preferred.
  • Experience and at ease working with various populations: multiple age groups, ethnic and socioeconomic backgrounds, and a generalized level of understanding across specialty care areas.
  • Experience managing multiple computer systems and tools.
  • 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).
  • Sound clinical foundation in maternal health, with expertise in pregnancy care, management of common complications (e.g., preeclampsia, gestational diabetes, preterm labor), and support for postpartum recovery, including physical and mental health considerations.
  • NICU and pediatric experience preferred but not required.
  • 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 be comfortable taking the lead in negotiating and accessing resources.
  • Ability to have positive impact on team by modeling and supporting change.
  • Understand, articulate and support the organization's mission, vision, goals and strategy.
  • Work efficiently towards 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 on a daily basis.


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, MI, MN, MO, ND, NE, OK, SD, TN, TX, VA, WI

The full salary grade for this position is $72,100 - $123,600. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $72,100 - $97,850. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data. In addition to compensation, Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees.

The compensation and benefits information is provided as of the date of this posting. Medica's compensation and benefits are subject to change at any time, with or without notice, subject to applicable law.

Eligibility to work in the US: Medica does not offer work visa sponsorship for this role. All candidates must be legally authorized to work in the United States at the time of application. Employment is contingent on verification of identity and eligibility to work in the United States.

About Medica Health Plans

Medica Health Plans is a non-profit health insurance company based in Minnesota. It was founded in 1975 and provides health insurance to individuals, families, and employers in Minnesota, North Dakota, South Dakota, and Wisconsin. Medica offers a variety of health plans, including HMO, POS, PPO, and Medicare Advantage plans. The company also offers dental, vision, and pharmacy benefits. Medica has received high ratings for customer satisfaction and quality of care. The company is committed to improving the health of its members and the communities it serves.
Learn more about Medica Health Plans
Size
1,700 employees
Industry
Founded
1975

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