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

Actalent

Care Manager

Milwaukee, WI

Job Title: Care Manager The Care Manager provides comprehensive case management and care ... Understanding of Medicare, Medicaid, BadgerCare, and managed care programs within the healthcare ...

TEEMA Group

Registered Nurse - RN

West Allis, WI · Remote

$50 - $56/hr

Hands-on experience in Medicare home health, hospice, palliative care, or geriatric case management. * Pain Management Expertise: In-depth knowledge of pain and symptom control strategies for ...

TEEMA Group

Registered Nurse - RN

West Allis, WI

$50 - $56/hr

Hands-on experience in Medicare home health, hospice, palliative care, or geriatric case management. * Pain Management Expertise: In-depth knowledge of pain and symptom control strategies for ...

TEEMA

Registered Nurse - RN

West Allis, WI · On-site

Hands-on experience in Medicare home health, hospice, palliative care, or geriatric case management. * Pain Management Expertise: In-depth knowledge of pain and symptom control strategies for ...

Actalent

RN Care Manager

Milwaukee, WI · On-site

Demonstrated experience in case management and care coordination for diverse populations, including older adults and individuals with disabilities. * Knowledge of Medicare, Medicaid, and managed care ...

Actalent

RN Care Manager

Milwaukee, WI · On-site

Demonstrated experience in case management and care coordination for diverse populations, including older adults and individuals with disabilities. * Knowledge of Medicare, Medicaid, and managed care ...

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All JobsMedicare Case JobsMedicare Case Manager JobsMedicare Case Manager Jobs in Racine, WI

Medicare Case Manager information

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How much do medicare case manager jobs pay per hour?

As of Sep 6, 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 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 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:

Medicare Case Manager jobs near you

Care Management - Nurse, Senior

Blue Shield of CA

Milwaukee, WI • On-site

Other

Posted 25 days ago

Job description

our Role

The Care Management team performs and case management (CM) activities demonstrating clinical judgment and independent analysis, collaborating with members and those involved with members care including clinical nurses and treating MDs. The Care Management Nurse, Senior will report to the Manager, Care Management. In this role you will determine, develop and implement the plan of care based on accurate assessment of the member and current or proposed treatment plan in cases of member inquiry, triage hub, chronic conditions, poly-pharmacy, pre-natal care, and voluntary member health assessment, in addition to indication of multiple monthly ER visits.

Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Please note that this position requires PST business hours.

Your Knowledge and Experience

  • Requires a current CA RN License

  • Bachelors of Science in Nursing or advanced degree preferred.

  • Certified Case Manager (CCM) Certification or is in process of completing certification when eligible based on CCM application requirements

  • Requires at least 5 years of prior experience in nursing, healthcare or related field

  • At least 3 years of managed care experience preferred

  • Demonstrated ability to independently assess, evaluate, and interpret clinical information and care planning.
  • Extensive knowledge of evidenced based clinical practice guidelines particularly for chronic conditions.
  • Incorporates professional judgment and critical thinking when determining medical necessity that promotes quality, cost-effective care.
  • Knowledge of Coordination of Care, Medicare regulations, prior authorization, level of care and length of stay criteria sets preferred
  • Able to operate PC-based software programs including proficiency in Microsoft Office 365 applications including Word, Excel, Outlook and Teams.

Hybrid Virtual Work

This role allows employees to work virtually full-time, however employees will be expected to come to the office based on business need.

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