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Case Management Analyst Jobs (NOW HIRING)

MedStar Health

Director Case Management

Columbia, MD · On-site

The Director of Case Management (DCM) is responsible for the operational functions the Case ... Drives continuous process improvement initiatives using data analytics and performance insights.

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How much do case management analyst jobs pay per year?

As of Aug 14, 2026, the average yearly pay for case management analyst in the United States is $82,660.00, according to ZipRecruiter salary data. Most workers in this role earn between $54,000.00 and $94,500.00 per year, depending on experience, location, and employer.

What does a case management analyst do?

A Case Management Analyst is responsible for evaluating, coordinating, and monitoring cases within an organization, often in healthcare, social services, or insurance. They analyze data, ensure compliance with policies, and help optimize processes to improve outcomes for clients or patients. Their duties may include reviewing case files, preparing reports, and collaborating with other professionals to provide effective solutions. The goal is to ensure cases are managed efficiently and clients receive the appropriate support and services.

What are the key skills and qualifications needed to thrive as a case management analyst?

To thrive as a Case Management Analyst, you need strong analytical abilities, attention to detail, and a relevant degree in fields such as social work, healthcare, or business administration. Familiarity with case management software, data analysis tools, and compliance regulations is typically required, and certifications like Certified Case Manager (CCM) can be advantageous. Excellent communication, organization, and problem-solving skills help you coordinate with stakeholders and address complex cases effectively. These competencies ensure accurate case evaluation, efficient resource use, and optimal outcomes for clients or patients.

What are some typical challenges a case management analyst may face when managing multiple cases simultaneously?

Case Management Analysts often juggle numerous cases at once, which requires exceptional organizational skills and attention to detail. A common challenge is prioritizing cases based on urgency and complexity while ensuring no case falls behind due to workload. Analysts must also coordinate with various stakeholders—such as clients, service providers, and internal teams—which can lead to communication hurdles if not managed proactively. Using case management software and regularly updating records helps maintain efficiency and accuracy despite these demands.
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Case Management Analyst jobs near you
Infographic showing various Case Management Analyst job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 14% Part Time, and 3% Contract. Highlights an 92% Physical, 3% Hybrid, and 5% Remote job distribution, with an average salary of $82,660 per year, or $39.7 per hour.

Director Case Management

MedStar Health

Columbia, MD • On-site

Full-time

Posted 29 days ago

Medstar Health rating

7.8

Company rating: 7.8 out of 10

Based on 239 frontline employees who took The Breakroom Quiz

130th of 887 rated healthcare providers

Job description

About the Job
General Summary of Position
The Director of Case Management provides strategic and operational leadership for the health plan's enterprise case management function across two health plans under a centralized clinical operations model. The Director of Case Management (DCM) is responsible for the operational functions the Case Management team including the direct supervision coaching and counseling of staff. The DCM will direct and coordinate the Case Management operations staff with specific focus on Person Centered Enrollee Care and the Enrollee Continuum of Care models. This role designs standardizes implements and optimizes care management programs to improve quality outcomes enhance enrollee experiences reduce avoidable utilization and ensure regulatory compliance. The Director of Case Management (DCM) oversees case management activities that may include behavioral health utilization management and care management functions and serves as a liaison to government and other regulatory agencies as well as internal departments. The Director monitors staff and program performance compares results against goals recommends improvements and decisions aligning with expected outcomes. The Director supports Managers managing case management coordination and care management staff. The Director ensures adherence of case management programs across markets while addressing unique state-specific regulatory and population needs partners closely with Utilization Management Pharmacy Quality Population Health Equity and Provider Relations to drive enterprise clinical performance.
Primary Duties and Responsibilities
  • Leads the enterprise case management strategy across both health plans ensuring alignment with clinical quality and financial goals.
  • Develops and manages the field-based activities of the Case Management Assessment Team (CMAT) of RN Field Case Managers to ensure person-centered enrollee care and strict contractual compliance.
  • Oversees and ensures the timely execution of Case Management activities related to Enrollee Discharge Planning Transitions of Care special benefit operations (for example transportation and personal care services) Behavioral Health Case Management and Special Population Services (for example unhoused enrollees and pediatric case management).
  • Establishes and maintains a monitored reporting cadence (for example reports and dashboards) for enrollees in case management that include annual assessments critical incidents special populations behavioral health and transitions of care coordination efforts.
  • Ensures dashboard oversight for the production and validation of case management activities including standardized goals and scorecards to support contractual compliance and both individual and health plan case management performance.
  • Standardizes case management policies workflows and documentation practices across markets while maintaining state-specific regulatory compliance.
  • Monitors and improves member engagement rates including outreach success care plan completion and sustained participation. Ensure seamless integration between Case Management and Utilization Management to reduce fragmentation and duplication of effort.
  • Partners with Pharmacy leadership to coordinate care for members utilizing high-cost or specialty medications.
  • Collaborates with Quality Improvement teams to close gaps in care and improve HEDIS and other performance metrics.
  • Develops strategies to reduce avoidable emergency department visits and hospital readmission through proactive care coordination.
  • Monitors medical expense impact and total cost of care trends related to care management interventions.
  • Establishes and monitor key performance indicators (KPIs) including engagement rates readmission rates care plan timeliness and staff productivity while driving measurable outcomes.
  • Ensures compliance with state Medicaid agencies CMS NCQA and contractual requirements across both health plans deploying corrective action plans where applicable.
  • Supervises and develops manager and supervisors ensuring strong leadership cascade and accountability within a centralized structure.
  • Designs and optimizes centralized staffing models and caseload distribution to ensure efficiency and effectiveness. Establish RE's/Reasonable Expectancy targets for the assigned work.
  • Drives continuous process improvement initiatives using data analytics and performance insights.
  • Partners with Finance and Actuarial team to evaluate the ROI of care management programs.
  • Supports value-based payment and alternative payment models aligning case management strategies with provider performance incentives.
  • Provides executive-level reporting and strategic recommendations to the VP of Clinical Operations and senior leadership.
  • Champions a culture of member-centered culturally competent care coordination that improves health equity and outcomes across both markets.
    • Minimal Qualifications
    Education
    • Bachelor's degree Nursing Social Work or related healthcare field required and
    • Master's degree Nursing (MSN) Public Health (MPH) Healthcare Administration (MHA) Business Administration (MBA) or related field preferred
    Experience
    • 8-10 years Progressive experience in managed care or health plan operations. required and
    • 5-7 years Leadership experience in case management care coordination or population health management. required and
    • Demonstrated experience overseeing complex case management programs in Medicaid managed care strongly preferred. required and
    • Experience leading multi-market or centralized teams preferred. required and
    • Proven track record of improving quality outcomes reducing avoidable utilization and managing medical expense trends. required and
    • Experience with regulatory audits (state Medicaid agencies CMS) and NCQA accreditation processes. required and
    • Experience implementing risk stratification tools and data-driven care models. required and
    • Prior experience collaborating with Utilization Management Pharmacy Quality and Provider Relations functions. required
    Licenses and Certifications
    • RN - Registered Nurse - State Licensure and/or Compact State Licensure Active unrestricted clinical license; Multi-state licensure or eligibility for licensure in Maryland and DC.(RN strongly preferred) Upon Hire required or
    • LCSW- License Clinical Social Worker Multi-state licensure or eligibility for licensure in Maryland and DC Upon Hire required or
    • other licensed clinicians may be considered Upon Hire required and
    • CCM - Certified Case Manager Certified Case Manager (CCM) or other nationally recognized case management certification Upon Hire required
    Knowledge Skills and Abilities
    • Strong knowledge of state Medicaid CMS NCQA and contractual requirements related to case management and care coordination.
    • Deep understanding of population health management social determinants of health and risk-based care models.
    • Financial acumen with the ability to interpret PMPM trends total cost of care data and ROI analysis.
    • Expertise in care transitions complex case management maternal health behavioral health integration and high-risk population management.
    • Ability to lead organization change within a centralized clinical operations model.
    • Strong analytical skills with the ability to translate data into actionable strategy.
    • Excellent executive-level communication and presentation skills.
    • Proven ability to build high-performing teams and drive accountability.
    • Skilled in cross-functional collaboration and stakeholder engagement.
    • Demonstrated commitment to culturally competent member-centered care.
    • Proficiency with care management platforms electronic health records and reporting tools.

    This position has a hiring range of
    USD $120,702.00 - USD $238,222.00 /Yr.

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    About Medstar Health

    Sourced by ZipRecruiter

    MedStar Health is dedicated to providing the highest quality care for people in Maryland and the Washington, D.C., region, while advancing the practice of medicine through education, innovation, and research. Our team of 32,000 includes physicians, nurses, residents, fellows, and many other clinical and non-clinical associates working in a variety of settings across our health system, including 10 hospitals and more than 300 community-based locations, the largest home health provider in the region, and highly respected institutes dedicated to research and innovation. As the medical education and clinical partner of Georgetown University for more than 20 years, MedStar Health is dedicated not only to teaching the next generation of doctors, but also to the continuing education, professional development, and personal fulfillment of our whole team. Together, we use the best of our minds and the best of our hearts to serve our patients, those who care for them, and our communities. It's how we treat people.

    Industry

    Health care and social assistance

    Company size

    10,000+ Employees

    Headquarters location

    Columbia, MD, US

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