Supervisor, Case Management

Medica's Case Management Supervisor is responsible for providing both operational oversight and strategic direction to an assigned team within the Case Management department. This role ensures the successful execution of daily activities while supporting broader departmental goals and maintaining the flexibility to adapt to evolving business needs. The supervisor leads both clinical and non-clinical staff, ensuring that strategic and operational processes are clearly defined, consistently maintained, and effectively communicated. This position requires regular collaboration with departments across Medica to support integrated care and organizational alignment.

In addition to staff supervision and development, the Case Management Supervisor plays a key role in relationship management. This includes supporting the Manager of Case Management in building and maintaining strong partnerships within Medica and with external vendors. These relationships are essential for prioritizing, coordinating, and integrating interventions that address the medical, behavioral, and social needs of targeted populations.

The supervisor also oversees case management projects, contributes to quality improvement initiatives, and monitors utilization data to support reporting to internal customers. The supervisor assists in the adoption and implementation of innovative case management models and transformational interventions aimed at addressing high-cost conditions and populations that influence medical expense trends. A critical aspect of the role involves supporting the integration of accreditation standards into program operations and ensuring compliance through the documentation of program plans, budgets, activities, and outcomes.

This position demands a strong commitment to customer service and the organization's core values. The supervisor is expected to foster professional and constructive relationships with peers, leadership, and external partners. Success in this role requires the ability to navigate both internal and external systems efficiently, facilitate change initiatives, and consistently model the behaviors and standards expected within the organization. A proactive approach to addressing customer needs in a timely and effective manner is essential.

Supervisory Responsibilities

The Case Management Supervisor is responsible for overseeing the daily responsibilities of the team, including recruiting, hiring, and training staff. This role ensures that team members are compliant with internal policies, procedures, and NCQA audit standards through regular audits and performance monitoring. The supervisor manages workloads, monitors staffing ratios, and conducts performance appraisals, while also recognizing and rewarding strong performance. They lead team meetings and collaborate with managers, supervisors, and team leads to coordinate departmental meetings, functions, and responsibilities. Additionally, the supervisor develops job descriptions and sets performance goals for team members, while providing budgetary consultation to support program operations and ensure they remain within established financial parameters.

A critical component of this role is ensuring that Case Managers are actively engaging members, their provider care teams, and Medica's care management resources. The goal is to implement care plans and support transitions in care that promote member self-management and clearly define accountability across the member's support network.

Key Accountabilities

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 and facilitate a positive approach to change among team members.
• Monitor team members' calls and casework to ensure staff is following 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 Complex Case Management Team

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  • Lead and supervise the program and team as outlined under the position Description section.
  • Ensure that 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 our 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
    • 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 plan 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, i.e. timecards, performance evaluations, call recordings, expense reports, etc.
  • 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 the Quality Audit results. Ensure recommendations from audits are evaluated and appropriate improvement measures are taken.
  
  
  
  

Minimum Qualifications

• Associate or Bachelor's degree in Nursing, or Master's degree in Clinical Social Work
• 5 years of related experience

Skills and Abilities

• Experience in a healthcare setting.
• Three to five years' experience and expertise in communicating with staff in different positions and all levels of management positions.
• Excellent customer service skills and proven team building skills.
• Excellent computer skills including Microsoft Word, Outlook, Power Point 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 the 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 to quality programs that result in targeted staff competencies.
• Strong leadership skills.

Required Certifications/ Licensure:

• Current, unrestricted RN or Advanced Practice Independent Social Work licensure
• Certified Case Manager (CCM) preferred, or ability and commitment to obtain within two years of hire required

This position is a Hub role, which requires an employee to occasionally come onsite to the designated office--Minnetonka, MN or Madison, WI--for applicable heads-up work. Frequency is determined by business need as decided by leadership.

The full salary range for this position is $77,100-$132,200. 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.

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.