Supervisor, Case Management

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.

About the role

The Case Management Supervisor provides operational leadership and strategic direction for an assigned case management team, ensuring effective daily operations and alignment with departmental goals. The role oversees clinical staff, supports integrated, evidence-based care management practices for maternal, pediatric, complex, and behavioral health populations, and collaborates across the organization to improve member outcomes.

The supervisor supports hiring and staff development, quality improvement initiatives, project oversight, monitoring performance and utilization data, and reporting insights to internal stakeholders, while assisting with the implementation of innovative care management models and interventions for high-risk, high-cost populations. The role also partners with internal leadership and stakeholders as well as external vendors to coordinate resources that address members' medical, behavioral, and social needs.

A key responsibility is supporting accreditation and regulatory compliance by integrating accreditation standards into program operations and ensuring appropriate documentation of program plans, outcomes, and performance measures. This role promotes a culture of customer service, collaboration, accountability, and continuous improvement.

Supervisory Responsibilities

• Oversee the daily responsibilities of the team, including recruiting, hiring, and training staff.
• Ensure team members are compliant with internal policies, procedures, and NCQA audit standards through regular audits and performance monitoring.
• Manage workloads, monitor staffing ratios, and conduct performance appraisals.
• Recognize and reward strong performance.
• Lead team meetings and collaborate with managers, supervisors, and team leads to coordinate departmental meetings, functions, and responsibilities.
• Develop job descriptions and set performance goals for team members.
• Provide budgetary consultation to support program operations and ensure they remain within established financial parameters.
• Ensure Case Managers actively engage members, their provider care teams, and Medica’s care management resources to implement care plans and support transitions in care that promote member self-management and define accountability across the member’s support network.
• Perform other duties as assigned.

Responsibilities

• Supervise and Maintain Efficient Department Operational Systems/Process
  • Ensure team compliance with all policies, procedures, and documentation standards, as well as departmental, regulatory, and accreditation requirements.
  • Escalate unresolved issues related to processes, procedures, or policies to the Manager.
  • Model change management philosophies and support a positive approach to change among team members.
  • Monitor team members’ calls and casework to ensure adherence to department guidelines, processes, and turn-around times.
  • Manage team performance and hold staff accountable for meeting standards related to quality, timeliness, policy compliance, effectiveness, attendance, and conduct.
  • Develop and implement action plans for staff whose performance does not meet expectations.
  • Collaborate with Human Resources and the Manager to ensure all personnel actions align with company policies and values.
  • Oversee personnel management activities, including interviewing, goal setting, performance reviews, and team-building efforts.
  • Assist in delivering new employee orientation and contribute to the development and communication of ongoing training and education programs.
  • Compile and report team and individual performance statistics to support planning and evaluation.
  • Support the Manager in defining and applying performance standards to monitor staff effectiveness.
  • Drive team performance toward departmental goals and communicate process gaps that may hinder progress to peers and leadership.
• Manage Performance of Case Management Team
  • Lead and supervise the program and team as outlined in the Position Overview.
  • Ensure Case Managers successfully meet and exceed process-oriented outcomes:
    • All members with complex illness are fully aware of their plan of care.
    • All providers caring for members with complex illness are fully aware of the plan of care.
    • All Medica care management services assisting with the case are fully aware of the plan of care.
    • Members are supported in transitions of care to improve outcomes and decrease utilization.
    • Outcomes are comprehensive plan-of-care driven.
  • Assess the training and development needs of each new employee to result in fully competent performance within one year.
  • Assess existing employees for training and development needs or performance improvement plans.
  • Provide team members with ongoing and consistent feedback, directed toward clinical excellence and accountability to department goals.
  • Regularly assess and measure team workload and staffing ratios; ensure workload is evenly distributed.
  • Develop and implement plans for backlog situations when needed.
  • Communicate workload and turn-around times.
  • Coach, encourage, and facilitate individual growth and development through specific, timely, and consistent feedback.
  • Conduct regular and timely one-on-one meetings.
  • Ensure timeliness and accuracy of all required administrative functions (e.g., timecards, performance evaluations, call recordings, expense reports).
  • Communicate and support management decisions in a positive manner to staff.
  • Be available to resolve issues, take escalated calls, and support case reviews.
  • Provide technical and clinical support to staff by researching and responding to their questions.
  • Coach staff on Quality Audit results.
  • Ensure recommendations from audits are evaluated and appropriate improvement measures are taken.

Requirements

• Associate or Bachelor’s degree in Nursing.
• 5 years of related work experience.
• Current, unrestricted RN license.
• Certified Case Manager (CCM) preferred, or ability and commitment to obtain within two years of hire.

Skills and Abilities

• 1+ years of leadership experience.
• Experience in a healthcare setting.
• 3-5 years of experience communicating with staff in different positions and all levels of management.
• Excellent customer service skills and proven team-building skills.
• Excellent computer skills, including Microsoft Word, Outlook, PowerPoint, and Excel.
• High degree of initiative and ability to work independently and within a group.
• Demonstrated effective project management skills, including use of project planning and tracking tools; development of achievable goals, objectives, and timelines; and innovative use of resources.
• Ability to plan, organize, and prioritize work effectively, including flexibility to accommodate frequent changes.
• Strong problem-solving skills.
• Knowledge of NCQA accreditation, Motivational Interviewing, Evidence-Based Medicine, and coaching.
• Consultant skills to articulate business needs and translate them into quality programs that result in targeted staff competencies.
• Strong leadership skills.

Schedule

This position is an Office role, which requires an employee to work onsite, on average, 3 days per week. We are open to candidates located near one of the following office locations: Minnetonka, MN or Madison, WI.

Pay

The full salary grade for this position is $78,700 - $134,900. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $78,700 - $118,020. 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.

Benefits

In addition to compensation, Medica offers a generous total rewards package that includes:

• Competitive medical, dental, and vision coverage.
• Paid time off (PTO) and holidays.
• Paid volunteer time off.
• 401K contributions.
• Caregiver services and many other benefits to support 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.