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Medicare Case Manager Jobs in Colorado (NOW HIRING)

Katmai

Maintains current directories of local Medicare providers, suppliers, and Institutions. * Evaluates case management process utilizing defined parameters such as admissions, length of stay, level of ...

ScionHealth

Case Manager II

Denver, CO · On-site

$43.82 - $55.57/hr

... of functions of case management, utilization review and management, and discharge planning ... Knowledge of Medicare benefits and insurance processes and contracts. * Knowledge of accreditation ...

HCA HealthONE Aurora

RN Case Manager

Aurora, CO · On-site

$40.35 - $58.87/hr

As a(an) RN Case Manager with HCA HealthONE Aurora you can be a part of an organization that is ... Medicare and insurance benefits, discharge criteria, and patient rights * Coordinating education ...

Mission Hospital

RN Case Manager

Aurora, CO · On-site

$40.35 - $58.87/hr

As a(an) RN Case Manager with HCA HealthONE Aurora you can be a part of an organization that is ... Medicare and insurance benefits, discharge criteria, and patient rights * Coordinating education ...

UnitedHealth Group

Case Manager - Per Diem

Boulder, CO · On-site

Demonstrates a working knowledge of managed care and Medicare health plans as well as reimbursement ... Case management experience or certification * Knowledge or understanding of community resources ...

UnitedHealth Group

Case Manager - Per Diem

Boulder, CO · On-site

Demonstrates a working knowledge of managed care and Medicare health plans as well as reimbursement ... Case management experience or certification * Knowledge or understanding of community resources ...

Mission Hospital

RN Case Manager PRN

Englewood, CO · On-site

$40.35 - $58.87/hr

RN Case Manager PRNHCA HealthONE Swedish Benefits HCA HealthONE Swedish offers a total rewards ... Medicare and insurance benefits, discharge criteria, and patient rights * Coordinating education ...

HCA HealthONE Swedish

RN Case Manager PRN

Englewood, CO · On-site

$40.35 - $58.87/hr

RN Case Manager PRNHCA HealthONE Swedish Benefits HCA HealthONE Swedish offers a total rewards ... Medicare and insurance benefits, discharge criteria, and patient rights * Coordinating education ...

Bannerhealth

Case Manager Care Coordination

Greeley, CO · On-site

Case Mgmt-Hosp Work Shift: Day Job Category: Clinical Care The future is full of possibilities. At ... Effectively communicates the plan across the continuum of care. 4. Maintains knowledge of Medicare ...

Lewis-Gale Medical Center

RN Case Manager PRN

Denver, CO · On-site

$40.35 - $58.87/hr

RN Case Manager PRN Hourly Wage Estimate: $40.35 - $58.87 / hour Learn more about the benefits ... Medicare and insurance benefits, discharge criteria, and patient rights * Coordinating education ...

IMAGE STRATEGIC PARTNERS

RN Case Manager

Pueblo, CO · On-site

$38 - $40/hr

Evaluates and admits only qualifying patients according to Medicare eligibility requirements ... Participates in case conferences/team meetings. * Makes visits as scheduled Why You'll Love Working ...

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Medicare Case Manager information

What are the key skills and qualifications needed to thrive as a Medicare case manager?

To thrive as a Medicare Case Manager, you need a background in nursing or social work, current licensure (such as RN or LCSW), and a thorough understanding of Medicare regulations and case management principles. Familiarity with case management software, electronic health records (EHR) systems, and utilization review tools is typically required. Exceptional communication, problem-solving, and organizational skills help you coordinate care, advocate for patients, and collaborate with multidisciplinary teams. These skills are crucial for ensuring patients receive appropriate, cost-effective care while maintaining compliance with Medicare guidelines.

What are the most common challenges Medicare case managers face when coordinating care for clients, and how can they effectively address them?

Medicare Case Managers often encounter challenges such as navigating complex insurance regulations, managing high caseloads, and addressing gaps in communication between healthcare providers, patients, and families. To overcome these obstacles, successful case managers stay up to date on Medicare policies, leverage electronic health records for better coordination, and employ strong interpersonal skills to advocate for clients. Regular collaboration with multidisciplinary teams and ongoing professional development also help in providing comprehensive, patient-centered care.

What is the difference between Medicare Case Manager vs Medical Social Worker?

AspectMedicare Case ManagerMedical Social Worker
CredentialsRN, LPN, or licensed healthcare professionalMaster's in Social Work (MSW) or equivalent, licensure required
Work EnvironmentHospitals, clinics, insurance companies, home healthHospitals, community clinics, patient homes, social service agencies
Employer & IndustryHealthcare providers, insurance companies, government programsHospitals, mental health facilities, social service organizations

Medicare Case Managers primarily coordinate care for Medicare beneficiaries, focusing on healthcare plans and services. Medical Social Workers provide emotional support, counseling, and connect patients to community resources. While both roles involve patient advocacy, Medicare Case Managers are more healthcare-focused, whereas Medical Social Workers address social and emotional needs.

Is Medicare Case Manager a good career path?

Medicare Case Managers coordinate healthcare services for Medicare beneficiaries, requiring knowledge of insurance policies, healthcare regulations, and strong communication skills. The role offers stable employment with opportunities for advancement and typically requires relevant certifications or experience in healthcare or social services.

What does a Medicare case manager do?

A Medicare case manager coordinates and manages care for Medicare beneficiaries, ensuring they receive appropriate services and benefits. They assess patient needs, develop care plans, communicate with healthcare providers, and help clients navigate Medicare policies and coverage options, often using case management software. Strong organizational and communication skills are essential for this role.

What are popular job titles related to Medicare Case Manager jobs in Colorado?

For Medicare Case Manager jobs in Colorado, the most frequently searched job titles are:

What job categories do people searching Medicare Case Manager jobs in Colorado look for?

The top searched job categories for Medicare Case Manager jobs in Colorado are:

What cities in Colorado are hiring for Medicare Case Manager jobs?

Cities in Colorado with the most Medicare Case Manager job openings:

Medicare Case Manager jobs near you
Infographic showing various Medicare Case Manager job openings in Colorado as of August 2026, with employment types broken down into 83% Full Time, 16% Part Time, and 1% Contract. Highlights an 87% Physical, 2% Hybrid, and 11% Remote job distribution.

RN Case Manager

Katmai

On-site

Full-time

Re-posted 17 days ago

Job description

SUMMARY:
Performs healthcare coordination and case management activities IAW Medical Treatment Facility (MTF) instructions.
ESSENTIAL DUTIES & RESPONSIBILITIES:
  • Ensures compliance with standards of care and practice (Accreditation Association for Joint Commission on Accreditation of Healthcare Organizations(JCAHO), Ambulatory Health Care (AAAHC) & Case Management Society of America (CMSA)).
  • Collaborates with military and civilian healthcare providers and staff and uses Utilization Management (UM) systems support to identify high-risk/high-cost patients within MTF population.
  • Determines eligibility for healthcare coordination/case management services.
  • Coordinates with healthcare providers to ensure appropriate appointment alternatives, access and quality of care.
  • Coordinates services for eligible patients based on subjective and objective assessment data and identified patient/family needs.
  • Facilitates a multidisciplinary team to develop a treatment plan to address all identified conditions and problems. Integrates health education, promotion and prevention activities utilizing available MTF and local civilian condition/disease management resources. Participates in the orientation, training, and evaluation of competency of newly assigned Case Management personnel.
  • Attends bi-weekly and as-needed multi-disciplinary discharge planning conferences within the MTF and as needed at the local treatment facilities.
  • Assists TRICARE eligible and Medicare-eligible patients in accessing local TRICARE and Medicare providers in conjunction with the MTF Referral Centers and the Central Referral Center.
  • Maintains current directories of local Medicare providers, suppliers, and Institutions.
  • Evaluates case management process utilizing defined parameters such as admissions, length of stay, level of care, Emergency Department/outpatient clinic visits and patient outcomes and institutes appropriate interventions.
  • Generates and maintains appropriate patient administrative records and provides upon request.
  • Reports monthly summary of care to Director, Medical Management (MM) or designee.
  • Conducts monthly evaluation, in conjunction with Primary Care Management (PCM) team, the benefit of case management. Closes case management cases when maximum patient benefit has been obtained.
  • Ensures a safe work environment and employee safe work habits.
  • Maintains regular and punctual attendance.
  • Performs all other duties as assigned.

SUPERVISORY RESPONSIBILITIES:
None.
Requirements
MINIMUM QUALIFICATIONS:
  • Bachelor of Science Degree in Nursing (BSN) from a National League of Nursing (NLN) or American Academy College of Nursing (AACN) accredited college or university as delineated by Headquarters United States Air Force Surgeon General.
  • Minimum of three (3) years of documented medical or surgical experience and at least one (1) year experience in Case Management.
  • Possess a current, active, full, and unrestricted license in any US United States or jurisdiction, be able to practice using a nurse compact state license or Enhanced Nurse Licensure Compact (eNLC) or have a license from any United States jurisdiction.
  • Must maintain a current, valid, and unrestricted State nursing/social worker license in good standing.
  • Extensive knowledge of TRICARE, Medicare/Medicaid services and benefits is mandatory.
  • Knowledge of professional care theories, principles, practices, and procedures to perform patient assessments with specific experience in the case management evaluation and assessment of pediatric, adult, and geriatric patients as appropriate.
  • Demonstrates knowledge, skill, and ability to use basic office automation and information management equipment and programs (i.e., word processing, database management, email, etc.).
  • Life Support Certifications: Must possess and maintain current Healthcare Provider Basic Life Support (BLS). This Certification must be current at all times, at no additional expense to the government.
  • Must obtain and maintain all required documents, certifications, licenses, etc. listed on the credentialling checklist, sent by Katmai's Credentialing Specialist, for this position for initial hire. All certifications listed must be maintained. Expired certifications are not valid.
  • Must obtain and maintain the site's required health screening and immunization requirements.
  • Must obtain and maintain any necessary security access and/or background checks.
  • Must obtain and maintain all required documents, certifications, licenses, etc. listed on the credentialling checklist, sent by Katmai's Credentialing Specialist, for this position for initial hire.

DESIRED QUALIFICATIONS & SKILLS:
  • Case Management certification desired.
  • Working knowledge of the military health care system as well as local community resources strongly preferred.
  • Experience in outpatient, home-health care, skilled nursing facility, hospice and mental health services are desired.
  • Experience with Medicare Eligible patients preferred.
  • Excellent patient assessment skills.
  • Excellent oral communication skills for patient education and telephone management of patients.
  • Sufficient initiative, interpersonal relationship skills and social sensitivity such that they can relate constructively to a variety of patients and healthcare staff from diverse backgrounds.
  • Ability to effectively read, write and speak English in order to communicate with all patients and other healthcare providers.
  • Ability to effectively communicate and collaborate with a diverse group of people for the purpose of informing the healthcare team of plans/actions, for teaching/education to benefit the patient/family and organization.
  • Excellent written communication skills to perform accurate documentation, both written and electronic, of all activity in accordance with requirements.
  • Demonstrates ability to prioritize, organize, problem-solve, and coordinate daily activities to support effective improvement in individual patients.

WORK SCHEDULE:
Full-time. May be required to work additional hours as needed to complete assignment or project.
TRAVEL:
All Market contractors are subject to working at a duty location at any of the MTFs or associated sub clinics within the Colorado Military Health System (CMHS).
DRIVING REQUIREMENTS:
None.
WORK ENVIRONMENT:
Work is performed primarily indoors at a well-lit military treatment facility such as a clinic, outpatient facility or hospital. The environment is normally air conditioned, but conditions may change dependent upon circumstances. Work may need to be performed in a fast-paced environment requiring quick thinking and rapid judgements. Employee will be exposed to a wide variety of clients in differing functions, personalities, and abilities. Exposure to bloodborne pathogens and bodily fluids, latex, radiation or other contaminants and safety issues. May be exposed to infection or diseases from contact with patients.
PHYSICAL DEMANDS:
Position consists of sitting for long periods of time, using hands/fingers, handling, reaching with hands and arms, speaking, or translating. Periods of walking, standing, bending, kneeling, stooping, crouching, and lifting boxes weighing up to 30 pounds. Moderate to extended periods of office work with heavy periods of computer usage. It is Katmai's business philosophy and practice to provide reasonable accommodations, according to applicable state and federal laws, to all qualified individuals with physical or mental disabilities.
Benefits
Compliance:
To be considered for this position, all applicants must apply on the company website, https://apply.workable.com/katmai/
We are a VEVRAA Federal Contractor.
We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, sexual orientation, gender identity or national origin, disability status, protected veteran status, marital status, familial status or any other characteristic protected by law.
Preference will be given to Ouzinkie Shareholders, Descendants of Shareholders and Spouses of Shareholders in accordance with Title 43 U.S. Code 1626(g) and Title 42 U.S. Code 2000e - 2(i).

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