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Medicare Case Manager Jobs in Racine, WI (NOW HIRING)

The RN Case Manager works collaboratively with interdisciplinary teams and team members both ... General knowledge of payor industry (Medicare, Medicaid, & Commercial insurance regulations ...

The RN Case Manager utilizes standards, guidelines, and protocols for care delivery and ... General knowledge of payor industry (Medicare, Medicaid, & Commercial insurance regulations ...

The RN Case Manager works collaboratively with interdisciplinary teams and team members both ... General knowledge of payor industry (Medicare, Medicaid, & Commercial insurance regulations ...

The RN Case Manager utilizes standards, guidelines, and protocols for care delivery and ... General knowledge of payor industry (Medicare, Medicaid, & Commercial insurance regulations ...

The RN Case Manager is responsible for identifying and coordinating patient/family care to support ... hospice benefit/Medicare, completion of a physical assessment, and entering the information ...

Prior utilization management or case management experience is required. A minimum of 5 years of ... Knowledge of Medicare inpatient only surgical list, Medicare guidelines for admission, working DRG ...

RN, Utilization Review

Menomonee Falls, WI ยท On-site

$34 - $52.70/hr

Prior utilization management or case management experience is required. A minimum of 5 years of ... Knowledge of Medicare inpatient only surgical list, Medicare guidelines for admission, working DRG ...

Strong understanding of OASIS documentation, home care protocols, and Medicare compliance ... Complete in-home annual competencies, evaluations, and supervise case management communication

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Medicare Case Manager information

See Racine, WI salary details

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How much do medicare case manager jobs pay per hour?

As of Jul 15, 2026, the average hourly pay for medicare case manager in Racine, WI is $21.52, according to ZipRecruiter salary data. Most workers in this role earn between $18.03 and $23.22 per hour, depending on experience, location, and employer.

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 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.

What is the highest paid case manager?

The highest paid case managers are often those with specialized certifications, extensive experience, and working in high-demand industries such as healthcare or insurance. Medicare case managers with advanced skills and leadership roles can earn salaries exceeding $80,000 annually, with top earners reaching over $100,000 in some regions or organizations.

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

To become a Medicare case manager, candidates typically need a bachelor's degree in nursing, social work, or a related healthcare field. Relevant experience in case management, strong communication skills, and knowledge of Medicare policies are also important; some roles may require certification such as the Certified Case Manager (CCM) credential.

What are the key skills and qualifications needed to thrive as a Medicare Case Manager, and why are they important?

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.

How to become a Medicare reviewer?

To become a Medicare reviewer, typically one needs a background in healthcare, such as nursing, health administration, or related fields, along with knowledge of Medicare policies and guidelines. Relevant certifications, like the Certified Medicare Counselor or similar credentials, can enhance qualifications. Experience with claims processing, medical review, or utilization management is also valuable in this role.

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 are popular job titles related to Medicare Case Manager jobs in Racine, WI? For Medicare Case Manager jobs in Racine, WI, the most frequently searched job titles are:
What job categories do people searching Medicare Case Manager jobs in Racine, WI look for? The top searched job categories for Medicare Case Manager jobs in Racine, WI are:
What cities near Racine, WI are hiring for Medicare Case Manager jobs? Cities near Racine, WI with the most Medicare Case Manager job openings:
Case Manager (FT)

$19.75 - $25.25/hr

Full-time

Medical, Dental, Life, Retirement

Re-posted 10 days ago


Job description

Case Manager

Position Summary:
The Case Manager, in collaboration with the physician, provides individual program management for each patient to ensure the patient's progression through the continuum of care in a manner that achieves the desired clinical and financial outcomes. Monitors and manages clinical and financial coordination of treatment plan of assigned patients to ensure timely, cost-effective, individualized service delivery. Works with rehabilitation patients with various disabilities including, but not limited to: spinal cord injury, brain injury, cerebrovascular accident, amputation, neurologic disorders, orthopedic conditions, and arthritis. Coordinates length of stay management within Medicare (CMS) guidelines and 60% compliance threshold. Provides community resources as appropriate including vocational rehabilitation resources.
Minimum Qualifications:
  • Current state licensure as a Registered Nurse or Licensed Social Worker
Desired Qualifications:
  • 2 years experience in a hospital setting
  • Certification in case management preferred.

Knowledge, Skills and Ability Requirements:
  • Excellent communication, negotiation, and conflict resolution skills required.
  • Knowledge of reimbursement systems preferred.
Join our team and you will experience a total rewards package to support your health, life, career and retirement including:
  • A supportive and collaborative work environment
  • Opportunities to progress in function, skill, and pay
  • A competitive wage scale
  • A comprehensive health and wellness package including medical, dental, and prescription drug coverage

We offer a benefits package that will best suit your familyรขโ‚ฌโ„ขs needs. You can choose from a variety of medical coverage plans that best fit your lifestyle. You also have the option to enroll in additional perks such as 401k, life insurance, and disability plans.
Milwaukee Rehabilitation Hospital is an EEO employer - M/F/Vets/Disabled