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Medicare Case Manager Jobs (NOW HIRING)

InnovaCare Admin Professionals

Case Manager

Saint Cloud, FL · On-site

$18.25 - $23.50/hr

Patient's medical records and CCMR 5. Contact ALL Medicare Capitated HMO "no shows". Document in ... Case Management Disease Management Transitions of Care Skills and Specifications Communication ...

COMMUNITY HEALTH GROUP

Case Manager I

Chula Vista, CA · On-site

$20.25 - $26/hr

Resolves Medicare member concerns in a timely manner by recommending and facilitating available ... Within one year of eligibility, must take the Certified Case Manager test. Must pass the test ...

COMMUNITY HEALTH GROUP

Case Manager I

Chula Vista, CA · On-site

$20.25 - $26/hr

Resolves Medicare member concerns in a timely manner by recommending and facilitating available ... Within one year of eligibility, must take the Certified Case Manager test. Must pass the test ...

COMMUNITY HEALTH GROUP

Case Manager I

Chula Vista, CA · On-site

$79K - $90K/yr

Resolves Medicare member concerns in a timely manner by recommending and facilitating available ... Within one year of eligibility, must take the Certified Case Manager test. Must pass the test ...

Amoskeag Health

Case Manager

Manchester, NH · On-site

$20 - $25.75/hr

You provide comprehensive case management, crisis services, and care coordination to children ... Medicare and insurance. Directs and assists clients with the resources to gain access to existing ...

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 ...

COMMUNITY HEALTH GROUP

Case Manager I

Chula Vista, CA · On-site

$79K - $90K/yr

Resolves Medicare member concerns in a timely manner by recommending and facilitating available ... Within one year of eligibility, must take the Certified Case Manager test. Must pass the test ...

Managed Staffing

Nurse Case Manager

IL · Remote

$37 - $38/hr

Seeking an experienced Nurse Case Manager II to support members enrolled in Medicare and Medicaid. This 100% remote role focuses on improving health outcomes through comprehensive care management and ...

EHG

Regional Case Manager

Clifton, NJ · On-site

Regional Case Manager Summary: The Case Management plays a critical role in centralizing and ... This position ensures timely authorization and continuation of care for residents under Medicare ...

GDIT

Case Manager

WV · On-site +1

$18 - $23.25/hr

... for Medicare & Medicaid Services (CMS). * Coordinate case-related activities among various ... Manage continuous quality improvement efforts to strengthen case intake, triage, review, and ...

Yale New Haven Health

Case Manager

New Haven, CT · On-site

$20 - $26/hr

The Case Manager is responsible and accountable for ensuring high-value patient care that is ... for Medicare notices of non-coverage and help provide appropriate documentation to appeal ...

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Medicare Case Manager information

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How much do medicare case manager jobs pay per hour?

As of Aug 20, 2026, the average hourly pay for medicare case manager in the United States is $22.95, according to ZipRecruiter salary data. Most workers in this role earn between $19.23 and $24.76 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.
More about Medicare Case Manager jobs

What cities are hiring for Medicare Case Manager jobs?

Cities with the most Medicare Case Manager job openings:

What states have the most Medicare Case Manager jobs?

States with the most job openings for Medicare Case Manager jobs include:

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

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

Medicare Case Manager jobs near you
Infographic showing various Medicare Case Manager job openings in the United States as of August 2026, with employment types broken down into 88% Full Time, 11% Part Time, and 1% Contract. Highlights an 81% Physical, 2% Hybrid, and 17% Remote job distribution, with an average salary of $47,743 per year, or $23 per hour.

Case Manager

InnovaCare Admin Professionals

Saint Cloud, FL • On-site

$18.25 - $23.50/hr

Full-time

Posted 7 days ago

Job description

InnovaCare Management Services Company, LLC

Job Summary:

The role of the Case Manager is to collaborate with clients by assessing, facilitating, planning and advocating for health needs on an individual basis. Successful outcomes cannot be achieved without specialized skills and knowledge applied throughout the process. These skills include, but are not limited to, positive relationship building, effective written/verbal communication, ability to effect change, perform critical analysis, plan and organize effectively and promote client/family autonomy. It is crucial for the Case Manager to have knowledge of funding resources, services, and clinical standards and outcomes.

Responsibilities:

1. Daily review of Hospital and Skilled Nursing Home inpatient list

Daily updates from Hospital and/or SNH Case Managers

To provide information to Hospital and/or SNH Case Manager

To coordinate post in patient admission services and office follow up

To obtain medical records from Hospital and/or SNH for office follow up

Family dynamics and support systems

2. Coordinate with PCP and Hospitalist Group Case Manager any possible admissions and/or ER diversions to a Skilled Nursing Home

3. Notify Skilled Nursing Home admitting physician and Case Manager of any possible admissions and provide medical information as needed

4. Maintain documentation: Patient's medical records and CCMR

5. Contact ALL Medicare Capitated HMO "no shows".

Document in the chart the reason and reschedule

6. Regular interaction with office Referral Coordinator to review elective/future inpatient and outpatient procedures.

Review w/ PCP

Review Pre-op clearance w/ office staff

Notify UM/Quality Department Director of upcoming procedures to be done at the hospital

7. Review all out of the area admissions and keep a daily report

Notify Claims Review Department of all out of area admissions

8. Daily review of office schedules to identify any patient's that need Case Management intervention.

9. Recent Hospital/SNH discharges Disease Management

Education on Advanced Directives, Community Services information

10. To identify patients for Disease Management and follow up according to protocol

CAD/CHF/COPD/DM/CKD Disease Management

11. New patient orientation: All HMO - Managed Care Advantage new members orientation within the 1st month of enrollment

Completion of: Mini Mental, ADL's screening, psychosocial assessment (See new patient orientation form)

Identification of any transfer for cause members or reallocation cases

12. To maintain monthly logs:

ESRD-End Stage Renal Disease Log: Form 2728 ESRD Medical Evidence Report

Hospice Log - Certification Forms

Oncology Log Transplant Log

CAD/CHF/COPD/ Diabetes / CKD Disease Management Log

13. To follow up protocols of:

Case Management

Disease Management

Transitions of Care Skills and Specifications

Communication / Coordinate sharing of pertaining information

Critical Thinking / Problem solving/Computer

Clinical background / Case screening and identification / Referral coordination

Negotiation and collaboration / Knowledge of community resources

Patient advocacy and empowerment /Conference and meetings

Innovacare participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S.

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