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Complex Case Manager Jobs in Orleans, MA (NOW HIRING)

Cape Cod Healthcare Inc.

Case Manager

Hyannis, MA · On-site

$42.04 - $89.99/hr

The Case Manager must assess patient needs utilizing established standards/Care Maps and other ... Identifies patients and families who have high-risk complex psychosocial/financial and legal needs ...

Marquis Health Consulting Services

RN Case Manager

Orleans, MA · On-site

$55 - $60/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

Coordinate and manage care for patients with chronic, acute, or complex medical conditions across ... Previous case management or utilization review experience preferred. * Direct patient care ...

Cape Cod Post Acute

RN Case Manager

Brewster, MA · On-site

$55 - $60/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

Coordinate and manage care for patients with chronic, acute, or complex medical conditions across ... Previous case management or utilization review experience preferred. * Direct patient care ...

i4 Search Group Healthcare

CAD/CAM Designer

Hyannis, MA · On-site

$35 - $45/hr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Manage digital manufacturing, light processing, nesting, and post-processing for 3D printed ... complex case parameters. Requirements & Qualifications * Experience: Proven experience as a CAD/CAM ...

Vinfen

Clinical Care Manager (RN)

Hyannis, MA

$90K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... complex medical and behavioral health needs. The RN will act as a Clinical Care Manager and is a ... A minimum of 3 years of clinical care management or case management experience preferred.

Department of Human Services

Dentist

Mashpee, MA

$123K/yr

  • Medical

  • Dental

... case management and treatment of medically complex cases; and obtaining medical clearances in order to provide comprehensive dental care. OR Completion of a two (2) year residency program in ...

Department of Human Services

Dentist

Mashpee, MA

$150K/yr

Performing case management and treatment of medically complex cases; and obtaining medical clearances in order to provide comprehensive dental care. You must meet all qualification requirements by ...

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Complex Case Manager information

See Orleans, MA salary details

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How much do complex case manager jobs pay per hour?

As of Aug 16, 2026, the average hourly pay for complex case manager in Orleans, MA is $25.89, according to ZipRecruiter salary data. Most workers in this role earn between $20.10 and $28.17 per hour, depending on experience, location, and employer.

What other jobs can a complex case manager do?

A complex case manager can transition into roles such as care coordinator, social worker, healthcare administrator, or patient advocate, utilizing skills in case planning, communication, and problem-solving. These positions often require knowledge of healthcare systems, documentation, and sometimes additional certifications or licenses.

What is a complex case manager?

A Complex Case Manager is a healthcare professional who coordinates care for patients with multiple or serious health conditions that require comprehensive management. They assess patient needs, develop care plans, and work closely with patients, families, and healthcare providers to ensure optimal outcomes. Complex Case Managers help navigate healthcare systems, address barriers to care, and connect patients with resources, aiming to improve quality of life and reduce hospitalizations. Their role is crucial in managing cases that involve chronic illnesses, behavioral health issues, or social challenges.

What are some common challenges faced by complex case managers and how can they be addressed?

Complex Case Managers often encounter challenges such as coordinating care across multiple providers, managing high caseloads, and addressing social determinants of health that impact patient outcomes. Effective communication, strong organizational skills, and leveraging interdisciplinary teamwork are key strategies to overcome these challenges. Additionally, staying updated on resources and support services in the community can help ensure clients receive comprehensive care. Regular team meetings and ongoing professional development also support success in this dynamic role.

What are the key skills and qualifications needed to thrive as a complex case manager, and why are they important?

To thrive as a Complex Case Manager, you need a background in healthcare or social work, typically with a relevant degree and licensure such as RN, LCSW, or CCM certification. Familiarity with case management software, electronic health records (EHRs), and care coordination tools is essential. Excellent communication, critical thinking, and problem-solving skills are vital for building trust with clients and collaborating with multidisciplinary teams. These competencies ensure effective management of complex patient needs, improved outcomes, and efficient resource utilization.

What cities near Orleans, MA are hiring for Complex Case Manager jobs?

Cities near Orleans, MA with the most Complex Case Manager job openings:

Complex Case Manager jobs near you
Infographic showing various Complex Case Manager job openings in Orleans, MA as of August 2026, with employment types broken down into 85% Full Time, 13% Part Time, and 2% Contract. Highlights an 87% Physical, 2% Hybrid, and 11% Remote job distribution, with an average salary of $53,845 per year, or $25.9 per hour.

Case Manager

Cape Cod Healthcare Inc.

Hyannis, MA • On-site

$42.04 - $89.99/hr

Full-time

Re-posted 18 days ago

Cape Cod Healthcare rating

6.7

Company rating: 6.7 out of 10

Based on 34 frontline employees who took The Breakroom Quiz

531st of 887 rated healthcare providers

Job description

Purpose of Position
The Case Manager is responsible for the timely facilitation and coordination of patient care for specific patient population or area of assignment. The job responsibilities include working effectively with the interdisciplinary team so as to plan and implement an individualized program of care that promotes high quality, efficient and cost effective care. The Case Manager must assess patient needs utilizing established standards/Care Maps and other approved clinical guidelines. Through ongoing communication and coordination with third party representatives the Case Manager will facilitate care that will meet established patient care needs while optimizing reimbursement.
Description
  1. Screen new admissions daily for discharge planning needs. Establish priority of visits based on screening criteria. Verify accuracy of demographics and payer information in and notify admissions of corrections.
  2. Patients with identified needs for follow-up are seen within one (1) business day of identification and the Initial Assessment is completed in InterQual®. Reassessments are done every three (3) days as needed for changes in medical status, diagnosis, or caregiver.
  3. Review appropriateness of patient's admission and level of care needs (Inpatient and Observation) utilizing InterQual® Criteria. Follow policy and procedure if Level of Care is not met.
  4. Initiates timely HINN Notices and letters of reinstatement. Coordinates patient appeal rights under the Discharge Appeals program.
  5. Identifies patients and families who have high-risk complex psychosocial/financial and legal needs and refers patients to appropriate resources.
  6. Responsible for utilization review on assigned unit. Facilitates third party reimbursement by responding to third party payer requests for concurrent clinical information in support of ongoing services, turnaround time by day end.
  7. Works closely with attending physician/interdisciplinary team to facilitate appropriate care and services. Ensures that the interdisciplinary care plan and the discharge plan are consistent with the patient's required needs and covered services.
  8. Participate/facilitate in unit's daily rounds.
  9. Advocates for patients through the development of effective partnerships with patient families, payers and healthcare team. Acts as patient advocate communicating with patients/families regarding adverse determinations and other issues related to insurance coverage and ongoing care requirements. Facilitates and maintains patient's independence in decision making when appropriate.
  10. Coordinate and communicate thorough and complete referral information to enhance a safe transfer of patient to other facilities or agencies. Complete all necessary paperwork based on need and regulation.
  11. Demonstrates knowledge of community resources and acts as resource to staff in providing safe and effective post hospital care.
  12. Participates and accurately applies approved standards of care/Care Maps and clinical pathways in evaluating and monitoring the patient's clinical course. Participates in the development and revision of pathways. Participates in care conferences on patients across the continuum.
  13. Evaluates continued length of stay of patients for appropriateness per recognized InterQual® criteria. Makes appropriate referrals to Physician Advisor if criteria is not met and resolution with the attending physician cannot be accomplished.
  14. Identifies days at risk for denial and initiate strategies to facilitate care and accomplish discharge.
  15. Assists medical coders by obtaining necessary diagnostic and procedural information to assure appropriate reimbursement.
  16. Maintains established departmental policies and procedures, objectives, quality assurance program, safety, environmental and Infection Control standards.
  17. Maintains core/clinical competency and current knowledge of regulatory and payer requirements to perform job responsibilities.
  18. Participates in education programs, in-services, and meetings as required.
  19. Recognizes/understands responsibility of this key role and the responsibility this position demands in direct support of high quality patient care delivery regardless of assignment. This will be measured by the accountability/initiative taken in the performance of daily duties and assignments as itemized in major accountabilities section of job description.
  20. Ability to work independently.
  21. Complies with policies regarding dress code.
  22. Performs other related duties as assigned or requested. Displays flexibility, cooperation and characteristics of a team member.

Consistently provides service excellence to all patients, family members, visitors, volunteers and co-workers in a manner that reflects Cape Cod Hospital's commitment to CARES: compassion, accountability, respect, excellence and service.
Qualifications
  • Ability to read, write and communicate in English;
  • Current registration as a Registered Nurse in the Commonwealth of Massachusetts;
  • Bachelor of Science Degree in Nursing preferred, (external applicants);
  • Certificate in Case Management or CPUM or specialty preferred;
  • Demonstrates competency with a minimum of 3 years acute care experience within the past 5 years with broad clinical experience in a hospital setting or case management .
  • Demonstrate recent knowledge/experience within past 4 years in Discharge Planning and Utilization review;
  • Working knowledge of InterQual®, or equivalent system.
  • Strong interpersonal and negotiation skills demonstrated by a positive attitude, pleasant, professional and cooperative demeanor, with patients, physicians, fellow employees, and insurance companies;
  • Excellent organization and time management skills;
  • Ability to work independently and effectively in a fast pace environment;
  • Ability to work productively in a stressful environment and effectively handle multiple projects and changing priorities;
  • Proficient computer skills with ability to utilize and integrate updated software systems into practice.

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