Manager Case Management

JOB REQUIREMENTS: Description 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're a team that owns our work with accountability, makes data-driven decisions, embraces continuous learning, and celebrates collaboration - because success is a team sport. It's our mission 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. The Manager, Case Management is responsible for daily operations and the performance of the Health Services Case Management team. This includes: Relationship building within Medica and its vendor partners to prioritize, integrate and coordinate interventions for population segments based on medical, behavioral and social needs Relationship building with provider care teams as accountable partners facilitating member self-care management Adoption of transformational interventions and case management models for conditions and populations driving medical expense trend Population specific care coordination Population specific complex case management EOL management Transitional care management (post-discharge) NCQA compliance Predictive modeling and proactive member identification Specialty medical condition management (i.e., transplant, pregnancy) The Manager, Case Management provides overall direction to clinical staff and is responsible for the implementation, evaluation, intervention and improvement of programs delivered for the Medica commercial and government lines of business. The case management activities in the team are engineered to deliver process oriented outcomes, through focus on a comprehensive established plan of care, collaborative interactions with the member and provider, and the Medica Case Manager assuming assertive, purposeful direction of the case. Performs other duties as assigned. Key Accountabilities Case Management and Transition of Care Program Operations Responsible for oversight and implementation of Case Management and Transition of Care Programs. Collaborates with Medica Case Management teams to assure integration across all Case Management Programs at Medica. Tracks and evaluates productivity, program performance and the performance guarantees. Develops program recommendations. Collaborates closely with Medica's business segments and clinical leadership to ensure seamless operations and service. Provides management, supervision, and direction to case management staff. Acts as a subject matter expert for case management for Medica, our clients and in project teams. Serves as key clinical contact in the... For full info follow application link. Equal Opportunity Employer including Veterans and Disabled Individuals ***** APPLICATION INSTRUCTIONS: Apply Online: ipc.us/t/B331913769704804