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Medical Case Management Jobs (NOW HIRING)

Choices Case Management

CA · Hybrid

$82K - $87K/yr

Our Medical Case Management Training Program equips dedicated RNs with the knowledge, tools, and mentorship needed to launch a successful career in workers' comp case management--focusing more on ...

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Medical Case Management information

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$15

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How much do medical case management jobs pay per hour?

As of Aug 31, 2026, the average hourly pay for medical case management in the United States is $27.89, according to ZipRecruiter salary data. Most workers in this role earn between $21.15 and $31.25 per hour, depending on experience, location, and employer.

What is medical case management?

Medical case management is a collaborative process in which a healthcare professional, often a nurse or social worker, assesses, plans, coordinates, and monitors the medical services required for a patient. The goal is to ensure that patients receive timely, appropriate, and cost-effective care, especially those with complex or chronic conditions. Case managers work closely with patients, their families, and healthcare providers to develop and implement individualized care plans, address barriers to treatment, and facilitate communication among all parties involved.

How does a medical case manager typically collaborate with healthcare providers and insurance companies?

Medical Case Managers serve as a vital link between patients, healthcare providers, and insurance companies. On a daily basis, they coordinate care plans, communicate patient needs to physicians and specialists, and ensure that recommended treatments are covered by insurance policies. Collaboration often involves frequent meetings, preparing detailed case reports, and advocating for the best patient outcomes while adhering to cost and policy guidelines. This role requires strong interpersonal skills and the ability to navigate complex healthcare systems, making teamwork and clear communication essential for success.

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

To thrive as a Medical Case Manager, you need a background in nursing, social work, or a related healthcare field, often with relevant certification such as CCM (Certified Case Manager). Familiarity with case management software, electronic health records (EHR), and healthcare regulations is crucial. Outstanding communication, problem-solving, and organizational skills help you advocate for patients and coordinate care across multidisciplinary teams. These skills ensure effective patient outcomes, efficient resource use, and seamless care transitions in complex healthcare environments.

What is the difference between Medical Case Management vs Medical Social Work?

AspectMedical Case ManagementMedical Social Work
CredentialsCertifications like CCM or CMC, relevant healthcare trainingLicenses such as LCSW or LISW, social work degrees
Work EnvironmentHospitals, clinics, insurance companiesHospitals, community health agencies, social service organizations
Employer & IndustryHealthcare providers, insurance companiesHealthcare facilities, social service agencies
Primary FocusCoordinating medical care, ensuring treatment adherenceAddressing social determinants, providing emotional support

While both roles involve working within healthcare settings, Medical Case Management focuses on coordinating medical treatments and services, whereas Medical Social Work emphasizes addressing social and emotional needs of patients. Understanding these differences helps in choosing the right career path or job search focus.

Is medical case management a good career?

Medical case management is a growing healthcare field that involves coordinating patient care, often requiring strong communication, organizational skills, and relevant certifications such as the CCM. It offers opportunities in hospitals, insurance companies, and healthcare agencies, with a focus on improving patient outcomes and managing complex cases. The role typically involves regular office hours and requires knowledge of healthcare systems and policies.

What do medical case managers do?

Medical case managers coordinate patient care by assessing medical needs, developing treatment plans, and ensuring appropriate services are provided. They work with healthcare providers, insurance companies, and patients to facilitate communication and manage resources effectively, often using case management software and requiring relevant certifications. Their goal is to improve health outcomes and streamline the healthcare process.

What qualifications do you need to be a medical case management?

Medical case managers typically need a bachelor's degree in nursing, social work, or a related healthcare field. Many employers prefer candidates with certification such as the Certified Case Manager (CCM) or Certified Disability Management Specialist (CDMS), along with strong communication and organizational skills.
More about Medical Case Management jobs

What cities are hiring for Medical Case Management jobs?

Cities with the most Medical Case Management job openings:

What states have the most Medical Case Management jobs?

States with the most job openings for Medical Case Management jobs include:

Medical Case Management jobs near you
Infographic showing various Medical Case Management job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 79% Full Time, 14% Part Time, and 6% Contract. Highlights an 87% Physical, 1% Hybrid, and 12% Remote job distribution, with an average salary of $58,003 per year, or $27.9 per hour.

Medical Case Management Supervisor

Health Promotion Council

Philadelphia, PA • On-site

Full-time

Re-posted 7 days ago

Job description

PHMC serves as both a direct service provider to individuals, families, and communities across the region and as an intermediary agent — managing large-scale contracts, government and philanthropic partnerships, and multidisciplinary initiatives that require operational sophistication, strategic leadership, and deep mission alignment.

The Medical Case Management Supervisor shall oversee the staffing and performance of Medical Case Managers (MCM) and HIV/PrEP Patient Navigators across the PHMC Health Network. This person shall possess a strong knowledge of the Philadelphia Division of HIV Health (DHH) Medical Case Management and PrEP standards and shall serve as a liaison to DHH around MCM activities.

The Medical Case Manager Supervisor will ensure that regular, ongoing, and high-quality supervision is provided and appropriately documented, and that all staff are connected to and complete all required trainings. The Medical Case Manager Supervisor will additionally ensure that the team and the patients it serves are connected to programs that specifically support people living with HIV. They will also ensure that they, the Medical Case Managers, and the PrEP Patient Navigators are fully trained on and aware of broader, non-HIV-specific community resources and know how connect patients to these services.

Lastly, this person will serve as a liaison between pharmaceutical benefits programs, insurance plans, the PHMC Health Network, and/or the patients regarding medical benefits, medical bills, billing questions, sliding fee schedule questions, and/or payment arrangements related to their medical care.

AGE/PATIENT POPULATIONS SERVED (Double-click on box to activate appropriate indicator)

Age of Patient Population Served Pediatric (birth - 19 yrs) Adult (19 – 64 yrs) Geriatric (65 yrs & older) Nonage Specific Task (N/A) Population Bariatric Patients: BMI greater than 40, or greater than 35 with weight related comorbidities Patient with exceptional communication needs Patient with developmental delays Patient at the end of life Patient under isolation precautions All Populations.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

  • Provide leadership, oversight, and weekly supervision to the HIV Medical Case Managers and PrEP Patient Navigators.
  • Serve as a spokesperson for the Medical Case Management program to DHH and be able to speak to MCM activities and workflows confidently and accurately.
  • Ensure compliance with all DHH and HRSA standards related to HIV Medical Case Management, HIV testing, and PrEP care coordination.
  •  Ensure that staff maintain accurate and timely documentation of all client contacts (using D.A.P. format), forms, and applications in EHR software and in CAREWare.
  • Conduct bi-weekly patient chart reviews and CAREWare audits to ensure documentation accuracy.
  • Ensure all DHH training requirements for MCM Supervisors are met.
  • Ensure MCMs and PrEP Patient Navigators complete all required internal and external trainings, and ensure all completed trainings are logged and reported, as needed, to DHH.
  • Conduct weekly individual supervision meetings with staff and accurately enter the corresponding service units into CAREWare.
  • Ensure programmatic and reporting oversight of the Psychosocial Support Group.
  • Collaborate with the interdisciplinary Health Network team in the evaluation of patient needs and treatment progress.
  • Ensure coordination and collaboration of the MCM and PrEP Patient Navigator teams with other Health Network social service programs.
  • Maintain a strong, up-to-date knowledge of community resources and public benefits.
  • Serve as a liaison between pharmaceutical benefits programs, insurance plans, the PHMC Health Network, and/or the patients regarding medical benefits, medical bills, billing questions, sliding fee schedule questions, and/or payment arrangements related to their medical care.
  • Provide trauma-informed therapeutic support in collaboration with an interdisciplinary team, including crises.
  • Perform analysis and reporting of MCM data as required by DHH.
  • Keeps abreast of all pertinent federal, state, DHH, and PHMC regulations, laws, and policies as they presently exist and as they change or are modified.
  • Comply with HIPAA and Confidentiality Policies and Procedures as they apply to the job.
  • Comply with Department of Public Health (DPH), The Joint Commission, and other accreditation and regulatory agencies' standards.
  • Adhere to all PHMC Policies and Procedures.

SKILLS:

  • Bilingual/bi-cultural a plus.
  • Exceptional leadership skills.
  • Must be able to effectively communicate with patients, families, medical providers, insurance and pharmaceutical providers, and community partners.
  • Exceptional ability to develop training and provide interdisciplinary education and instruction to staff and community partners.
  • Strong ability to work with staff across disciplines.
  • Strong data management and presentation skills.
  • Strong time management and organizational skills.
  • Must demonstrate sound judgement and initiative.
  • Proficient with Microsoft Word, PowerPoint, and Excel.
  • Comfort and flexibility working in a fast-paced health environment.
  • Ability to work independently as well as in a team environment.

EXPERIENCE:

  • 2 years of medical case management and/or PrEP care coordination experience required.

EDUCATION REQUIREMENT:

  • Masters’ degree from an accredited university is required.
  • In lieu of a master's degree, 3 years of medical case management and/or PreP care coordination experience required, and a bachelor's degree in social work, psychology, or sociology, or related field.

WORK ENVIRONMENT:

Moderate noise (examples: business office with computers and printers, light traffic).

Shared work environment.

The primary work environment is a medical facility, with a degree of exposure to tuberculosis and other air-borne diseases that may require the use of personal protective equipment.

PHMC is an Equal Opportunity and E-Verify employer and is committed to creating a diverse and inclusive workplace free from discrimination and harassment.

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