Provide member-centered, evidence-based care coordination for individuals with complex illnesses and transplant needs. Ensure all providers and members are aligned with a comprehensive plan of care to reduce illness burden and healthcare costs.
Medica
8 Remote Job Openings at Medica
Responsible for the clinical review, investigation, and resolution of member and provider appeals and grievances. The role involves collaborating with medical directors to ensure regulatory compliance and monitoring the impact of decisions on STARs performance.
Drive new business sales by managing strategic relationships with brokers and consultants for commercial large group business. Develop strategic sales plans and lead RFP responses to provide tailored healthcare solutions for clients.
Care Coordinator II or III RN or Licensed SW (7 county metro area in MN)
Medica
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Full Time
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a month ago
Medica
Care Coordinators manage a caseload of members to create individualized care plans and coordinate the delivery of medical and social services. They also provide education on benefits and serve as a primary contact for members while partnering with providers and county entities.
The County Engagement Manager represents Medica by building and strengthening relationships with counties, community partners, and members. They are responsible for organizing community events, facilitating meetings, and maintaining detailed records of outreach activities in the CRM.
The Sales Relationship Manager is responsible for driving new business sales and managing strategic relationships with brokers and consultants. This role involves executing strategic sales plans, leading RFP responses, and providing consultative solutions tailored to client healthcare needs.
The County Engagement Manager acts as the primary liaison for tribal nations and counties to promote Medica's healthcare programs and services. They are responsible for building community partnerships, facilitating member consultations, and maintaining detailed engagement records.
The Commercial Sales Relationship Manager is responsible for driving new business sales and managing strategic relationships within the Prevea 360 market, focusing on cultivating broker partnerships and identifying business opportunities. Key accountabilities include developing strategic sales plans, leading RFP responses, serving as the primary contact for brokers, and maintaining deep product knowledge.
