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Medicaid Case Worker Jobs (NOW HIRING)

KALESTA HEALTHCARE GROUP

MDS CONSULTANT RN

Rocklin, CA

$38.75 - $46.75/hr

... Deep working knowledge of RAI, PDPM, QMs, and Five-Star data Experience with state Medicaid case mix systems Based in or relocating to Northern California Travel: ~50-75% to assigned Northern ...

Hougum Law Firm LLC

Medicaid Coordinator

Wausau, WI · On-site

... working in an estate planning, elder law, or Medicaid planning firm. * Familiarity with Medicaid eligibility rules, asset limits, and application procedures. * Experience with legal case management ...

Miller Law Office, PLLC

Medicaid Specialist

Plano, TX

$65K/yr

... case status and proactively follow up with HHSC and nursing facility business offices - Build and ... Working knowledge of Medicaid eligibility rules, asset spend-down strategies, Qualified Income ...

Queens Blvd Extended Care Facility

Be Seen First

Medicaid Coordinator

Woodside, NY · On-site

$50K - $59K/yr

Monitor case statuses and follow up on pending applications or required documentation. * Coordinate ... experience working with Medicaid, public benefits, or healthcare eligibility programs (NYC ...

VIP Care Management

Medicaid Specialist

Lantana, FL · On-site

$40K - $50K/yr

... case approval and prepare file for annual review. · Collaborate with a team of elder-care ... What You Bring · 2+ years' experience working professionally with seniors and their families. · ...

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Medicaid Case Worker information

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How much do medicaid case worker jobs pay per year?

As of Sep 6, 2026, the average yearly pay for medicaid case worker in the United States is $47,429.00, according to ZipRecruiter salary data. Most workers in this role earn between $38,500.00 and $54,500.00 per year, depending on experience, location, and employer.

What is a Medicaid case worker?

A Medicaid Case Worker helps individuals and families determine their eligibility for Medicaid benefits and assists them with the application process. They review financial and personal information, explain program requirements, and ensure compliance with state and federal guidelines. Additionally, they may provide referrals to other social services and offer ongoing support to help clients maintain their benefits. Their role is essential in connecting vulnerable populations to necessary healthcare services.

What skills and qualifications are needed to be a Medicaid case worker?

To thrive as a Medicaid Case Worker, you need a solid understanding of public health policies, case management, and eligibility determination, typically supported by a degree in social work or a related field. Proficiency with case management software, Medicaid systems, and client data tools is often required. Strong interpersonal skills, empathy, attention to detail, and effective communication are essential soft skills in this position. These abilities are crucial for accurately assessing client needs, managing caseloads efficiently, and ensuring eligible individuals receive appropriate services.

What challenges might a Medicaid case worker face on the job?

Medicaid Case Workers often manage a high volume of clients, each with unique and sometimes complex needs, which can make prioritization and organization challenging. Navigating frequent changes in Medicaid regulations and policies requires ongoing learning and adaptability. Additionally, workers may encounter emotionally difficult situations while supporting clients facing significant financial or health hardships. However, these challenges are balanced by the rewarding opportunity to make a tangible impact in people's lives.

How to become a Medicaid case worker?

To become a Medicaid case worker, candidates typically need a high school diploma or equivalent, with some positions requiring a bachelor's degree in social work, healthcare, or a related field. Relevant skills include case management, knowledge of Medicaid policies, and strong communication abilities; certification or training in Medicaid programs may also be beneficial. Employment often requires background checks and may involve working in government or healthcare settings with regular hours.

What does a Medicaid case worker do?

A Medicaid case worker evaluates applicants' eligibility for Medicaid benefits, assists clients in completing necessary paperwork, and ensures they receive appropriate healthcare coverage. They also coordinate with healthcare providers and maintain case records, often working within government or social service agencies to support clients' access to healthcare services.
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What states have the most Medicaid Case Worker jobs?

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What job categories do people searching Medicaid Case Worker jobs look for?

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Medicaid Case Worker jobs near you
Infographic showing various Medicaid Case Worker job openings in the United States as of August 2026, with employment types broken down into 2% As Needed, 79% Full Time, 16% Part Time, and 3% Contract. Highlights an 86% Physical, 4% Hybrid, and 10% Remote job distribution, with an average salary of $47,429 per year, or $22.8 per hour.

MDS CONSULTANT RN

KALESTA HEALTHCARE GROUP

Rocklin, CA

$38.75 - $46.75/hr

Full-time

Re-posted 27 days ago

Job description

Regional MDS Consultant

Full-time · Monday–Friday · California

Company Overview

Kalesta Healthcare Group operates 30 skilled nursing and senior living communities across California, Washington, and Oregon. We're building a clinical consulting infrastructure that drives consistent outcomes across our portfolio — and that starts with getting MDS right at every site.

The Role

We're looking for an MDS Consultant to own assessment accuracy, PDPM integrity, and MDS Coordinator development across our Northern California SNFs. This isn't a compliance-checker role. You'll be the regional subject matter expert — partnering with facility teams to close documentation gaps, optimize case mix, and build coordinator competency that holds between your visits. You report to the Chief Nursing Officer and work alongside our Regional Clinical Consultants.

What You'll Own

Assessment & Compliance

· Oversight of MDS submissions, CAA accuracy, and timeliness across assigned facilities

· Compliance with CMS, state, and corporate standards for assessment and care planning

· Audit and trend analysis of MDS-related deficiencies with actionable corrective plans

PDPM & Reimbursement

· Accurate PDPM coding, case mix grouping, and clinical documentation review

· Identification of coding and clinical capture gaps — and the follow-through to close them

· Cross-functional alignment with therapy, nursing, and billing on resource utilization

MDS Coordinator Development

· Direct coaching, onboarding, and competency development for facility-based MDS Coordinators

· Monthly or quarterly education sessions on RAI updates, PDPM changes, and state Medicaid case mix

· Building consistency in documentation practices that doesn't depend on your presence

What We're Looking For

Required Preferred

Active California RN license Prior regional or multi-site consulting experience

3+ years as MDS Coordinator in an SNF PCC proficiency

Deep working knowledge of RAI, PDPM, QMs, and

Five-Star data Experience with state Medicaid case mix systems

Based in or relocating to Northern California

Travel: ~50–75% to assigned Northern California SNFs.

Why Kalesta You'll have direct access to CNO-level leadership and visibility into portfolio-wide strategy — not just the four walls of one building. We're a growing regional operator that moves faster than national chains. If you've been doing this work at the facility level and are ready to scale your impact, this is that next step.

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