Care Coordinator II RN

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.  

Responsible for the provision and oversight of care coordination services for a caseload of state and public program care coordinated Medica members.

Provide, coordinate, and manage the delivery of individualized care, services, and plans of care to Medica members. Serve as the primary care coordination contact for members.

Provide care coordination services in accordance with all Regulatory and Compliance requirements and the Medica Care Coordination Model of Care. Performs other duties as assigned. 

Key Accountabilities 

• Provide required Medica member assessment visits

  • Completes regulatory required member assessments to assess medical, behavioral, mental health and social needs of members

  • Determine, create, and manage the delivery of medical and social services to members.

  • Member Assessment visits occur via in-person settings and/or telephonic settings.

• Provide care coordination services to Medica members

  • Provide, coordinate, and manage the delivery of individualized care, services, and plans of care to Medica members.

  • Serve as the primary care coordination contact for members.

  • Provide care coordination in accordance with the Medica Care Coordination Model of Care.

  • Documents in the Medica member Guiding Care platform.

  • Maintains MnCHOICES certification per the regulatory compliance requirement.

  • Manages waivered services for members.

  • Customer Service-Engages with members and delivers a positive member experience.

• Transition of Care - Care Coordination
  

  • Provides Transition of Care, care coordination services to members, during times of a transition of care, in accordance with regulatory and compliance requirements

  • Provides interdisciplinary collaboration and management of a member’s transition of care with hospital, health systems, members, member family, service providers and others key partners.

• Care Coordination department and team support

  • Partners with the care coordinator team and care coordination department to support overall member care coordination service needs.

  • Provides care coordination Triage call coverage to support the care coordination team and the Medica members.

  • Participates in IDT meetings within the department.

  • Participates in routine department, team, and individual care coordination meetings.

  • Maintains continuous education licensure requirements and department requirements.

Registered Nurse (RN) Qualifications

• RN Diploma or Degree in Nursing (Associates or Bachelors) + a minimum of 2 years’ experience in community based services, OR
• Bachelor’s degree in Nursing with a Public Health Certification + a minimum of 1 year experience in community based services
• 3+ years of experience beyond degree

Required Certification/ Licensure

• Active, unrestricted RN License in the state of MN Required
• MnCHOICES Certified Assessor Training (MNCAT) preferred or ability to obtain within 21 days of employment
• Public Health Certification preferred, however not required

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 $65,000 - $111,500. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $65,000 - $88,255. 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. 

We are an Equal Opportunity employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.