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

AlpineCare

Clinical Manager

Milwaukee, WI · On-site

Strong understanding of OASIS documentation, home care protocols, and Medicare compliance ... Facilitate team case conferences and participate in management and staff meetings * Serve as backup ...

TEEMA Group

Registered Nurse - RN

West Allis, WI · On-site

$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 ...

PRIDE Health

Travel Nurse RN - Home Health

Milwaukee, WI · On-site

$2.3K/wk

... Medicare Home Health patients in their homes. The RN will deliver care in accordance with physician orders and individualized Plans of Care while collaborating with RN Case Managers, Clinical ...

mkecounty

ADRC Professional

Milwaukee, WI · On-site

$26.25 - $28/hr

Accurately and thoroughly document each interaction with customers in the case management system ... and Medicare Savings Programs. * Participate in internal and external work groups, process ...

mkecounty

ADRC Professional

Milwaukee, WI

$26.25 - $28/hr

Accurately and thoroughly document each interaction with customers in the case management system ... and Medicare Savings Programs. * Participate in internal and external work groups, process ...

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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 Aug 14, 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 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.

Is CMS a good career path?

A Medicare Case Manager is a healthcare professional who coordinates Medicare-related services, often requiring knowledge of insurance policies and patient advocacy. The role offers stable employment with opportunities for advancement and typically requires relevant certifications and strong communication skills. It can be a rewarding career for those interested in healthcare administration and patient support.

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:

Medicare Case Manager jobs near you

Field Care Manager, Behavioral Health

Humana

Waukegan, IL

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 21 days ago

Humana rating

8.0

Company rating: 8.0 out of 10

Based on 265 frontline employees who took The Breakroom Quiz

163rd of 307 rated insurance

Job description

Become a part of our caring community
Humana is looking for a Field Care Manager, Behavioral Health to join the IL Medicaid team. In this position, you will report to the Manager, Care Management and connect with members both face-to-face and telephonically. The Field Care Manager serves as the primary point of contact, providing integrated care to ensure members receive timely, high-quality, and coordination services that meet their needs. You will employ a variety of strategies, approaches, and techniques to manage a member's health issues and resolve barriers that hinder effective care. Using a holistic, person-centered approach, you will enhance behavioral health outcomes, reduce care gaps and support Illinois' FIDE population through comprehensive, integrated behavioral health care management.

Position Responsibilities:

  • Utilize high-quality, evidence-based behavioral health services through personalized care coordination, crisis intervention, peer support, and strong collaboration with medical and behavioral health providers.

  • Provide comprehensive, integrated support to members experiencing behavioral health conditions, including children, adolescents, adults with serious mental illness (SMI) and serious emotional disturbance (SED),Substance Use Disorders(SUD) and justice-involved members.

  • Engage members in their own communities, meeting them face-to-face whenever possible to build trust and facilitate meaningful care coordination.

  • Coordinate behavioral health and medical services, ensuring appropriate provider engagement and adherence to treatment plans.

  • Improve member's health literacy while simultaneously addressing health related social needs to positively impact member's healthcare outcomes and well-being.

  • Serve as the driver of the member's interdisciplinary care team (ICT), overseeing care planning, transitions, and service delivery.

  • Facilitate ICT meetings, ensuring communication among providers, Service Coordinators, and Care Management Extenders.

  • Proactively support transition of care efforts.

  • Will work with autonomy but reach out when support is needed.

  • Collaborate with internal departments, providers, and community-based organizations to link to appropriate services and create a seamless, culturally competent care experience that respects the members' preferences and needs.

  • Follow processes and procedures to ensure compliance with regulatory requirements by the Illinois Department of Human Services (IDHS), Center for Medicare and Medicaid Services (CMS) and the National Committee on Quality Assurance (NCQA).
    Upon hire, this role will be assigned to support either MLTSS or LTSS based on business needs.


Use your skills to make an impact

EARN A $5,000 HIRING BONUS! $2500 is paid after 6 months (180 days) of employment and $2500 is paid after 1 year (365 days) of employment. You must be employed until those dates to be eligible to receive the payment.

Humana pays 100% of eligible tuition expenses and mandatory fees up front to the educational institution and reimburses for qualifying non-tuition expenses (up to $5,000 per funding year).


Required Qualifications

  • Must reside in Illinois

  • Active Illinois license in LCSW, LMFT or LCPC (Nosuperviseesor provisional licenses)

  • 2+ years of post-degree clinical experience in behavioral health setting.

  • Case management experience working with complex SMI, SUD, SED population.

  • Ability to travel to region-based facilities and homes for face-to-face assessments.

  • Ability to use a variety of electronic information applications/software programs including electronic medical records.

  • Intermediate to Advanced computer skills and experience with Microsoft Word, Outlook, and Excel.

  • Valid driver's license, car insurance, and reliable transportation.

Preferred Qualifications

  • Case Management Certification (CCM)

  • 3+ years of in-home assessment or care coordination experience.

  • Experience working with Medicare, Medicaid and dual-eligible populations

  • Field Case Management Experience

  • Knowledge of community health and social service agencies and additional community resources

  • Previous managed care experience

  • Bilingual

Additional Information

  • Workstyle:This is a remote position that will require you to travel.

  • Travel:Up to 75% of the time for collaboration and face-to-face meetings and field interactions with staff, providers, members, and their families.

  • Workdays and Hours:Monday - Friday; 8:00am - 5:00pm Central Standard Time (CST).

  • This role is considered patient facing and is part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.

  • This role is part of Humana's driver safety program and therefore requires an individual to have a valid state driver's license and are expected to maintain personal vehicle liability insurance.Individualmust carry vehicle insurance in accordance with their residing state minimum required limits, or $25,000 bodily injury per person/$25,000 bodily injury per event /$10,000 for property damage or whichever is higher.

WAH Internet Statement

  • To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

  • At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.

  • Satellite, cellular and microwave connection can be used only if approved by leadership.

  • Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.

  • Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Interview Format

As part of our hiring process for this opportunity, we will be using an interviewing technology calledHireVueto enhance our hiring and decision-making ability.HireVueallows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

This role is considered patient facing and is part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.

This role is part of Humana's driver safety program and therefore requires an individual to have a valid state driver's license and are expected to maintain personal vehicle liability insurance.Individual must carry vehicle insurance in accordance with their residing state minimum required limits, or $25,000 bodily injury per person/$25,000 bodily injury per event /$10,000 for property damage or whichever is higher.

Work at Home Requirements: To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.


$65,000 - $88,600 per year


This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About us
About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer atHumana.comand atCenterWell.com.


Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

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About Humana

Sourced by ZipRecruiter

Humana Inc., headquartered in Louisville, KY., is a leading health care company that offers a wide range of insurance products and health and wellness services that incorporate an integrated approach to lifelong well-being. By leveraging the strengths of its core businesses, Humana believes it can better explore opportunities for existing and emerging adjacencies in health care that can further enhance wellness opportunities for the millions of people across the nation with whom the company has relationships.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Louisville, KY, US

Year founded

1961

Social media

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