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Medicare Case Manager Jobs (NOW HIRING)

Forrest General Hospital

CASE MANAGER

Hattiesburg, MS · On-site

$16.75 - $21.50/hr

Issues Medicare hospital notices as indicated. * Collaborates with physician advisors, attending ... The Case Manager in the Utilization Management (UM) role is involved in utilization review ...

South Shore Health

Case Manager

Weymouth, MA · On-site

$117K - $170K/yr

The Case Manager is on-site and available seven (7) days a week as well as holidays and, therefore ... Issues the termination letter for the Medicare patient e - Reinstates insurance coverage when ...

Skilled Wound Care

Case Manager

Los Angeles, CA

$25 - $29/hr

The Case Manager - SNF & Insurance Coordination is responsible for investigating and resolving ... Identify patients who have Medicare Part A only and determine appropriate next steps for coverage ...

Skilled Wound Care

Case Manager

Los Angeles, CA

$25 - $29/hr

The Case Manager - SNF & Insurance Coordination is responsible for investigating and resolving ... Identify patients who have Medicare Part A only and determine appropriate next steps for coverage ...

Skilled Wound Care

Case Manager

Los Angeles, CA · On-site

$25 - $29/hr

The Case Manager - SNF & Insurance Coordination is responsible for investigating and resolving ... Identify patients who have Medicare Part A only and determine appropriate next steps for coverage ...

Arnot Health System

Case Manager - AOMC

Elmira, NY · On-site

$40.56 - $54.55/hr

CASE MANAGER **This is an onsite position. MAIN FUNCTION: The Case Manager coordinates, negotiates ... Prepares Medicare/Non Medicare hospital notices of no coverage (HINN) when patient's level of care ...

Midland Health

Case Manager

Midland, TX · On-site

$19.75 - $25.25/hr

Case management is a collaborative process that assesses, plans, implements, coordinates, monitors ... Medicare, Medicaid, and Social Security programs. • Possesses knowledge of current and available ...

Midland Health

Case Manager

Midland, TX

$19.75 - $25.25/hr

Case management is a collaborative process that assesses, plans, implements, coordinates, monitors ... Medicare, Medicaid, and Social Security programs. · Possesses knowledge of current and available ...

Midland Health

Case Manager

Midland, TX

$19.75 - $25.25/hr

Case management is a collaborative process that assesses, plans, implements, coordinates, monitors ... Possesses knowledge of current and available Medicare, Medicaid, and Social Security programs.

Arnot Health System

Case Manager - AOMC

Elmira, NY · On-site

$40.56 - $50.05/hr

CASE MANAGER **This is an onsite position. MAIN FUNCTION: The Case Manager coordinates, negotiates ... Prepares Medicare/Non Medicare hospital notices of no coverage (HINN) when patient's level of care ...

Arnot Health System

Case Manager - AOMC

Elmira, NY · On-site

$40.56 - $54.55/hr

CASE MANAGER **This is an onsite position. MAIN FUNCTION: The Case Manager coordinates, negotiates ... Prepares Medicare/Non Medicare hospital notices of no coverage (HINN) when patient's level of care ...

Arnot Health System

Case Manager - AOMC

Elmira, NY · On-site

$40.56 - $50.05/hr

CASE MANAGER **This is an onsite position. MAIN FUNCTION: The Case Manager coordinates, negotiates ... Prepares Medicare/Non Medicare hospital notices of no coverage (HINN) when patient's level of care ...

Arnot Health System

Case Manager - AOMC

Elmira, NY · On-site

$40.56 - $50.05/hr

CASE MANAGER **This is an onsite position. MAIN FUNCTION: The Case Manager coordinates, negotiates ... Prepares Medicare/Non Medicare hospital notices of no coverage (HINN) when patient's level of care ...

Nevada Regional Medical Center

Case Manager

Nevada, MO · On-site

$20.45/hr

MEDICARE INFORMATION * PRICING ESTIMATOR * PRICING FAQs * CAREERS * APPLY NOW * EMPLOYMENT BENEFITS ... PRIMARY CARE Job Openings >> Case Manager Case Manager Summary Title: Case Manager ID: 1530 ...

Arnot Health System

Case Manager - AOMC

Elmira, NY · On-site

$40.56 - $50.05/hr

CASE MANAGER **This is an onsite position. MAIN FUNCTION: The Case Manager coordinates, negotiates ... Prepares Medicare/Non Medicare hospital notices of no coverage (HINN) when patient's level of care ...

RAM Recruiting

Case Manager

Valley Stream, NY

$21 - $27/hr

A growing skilled nursing organization is seeking a Case Manager to support care coordination ... Medicare, Medicaid, and post-acute care processes preferred What's Being Offered • Competitive ...

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Medicare Case Manager information

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How much do medicare case manager jobs pay per hour?

As of Jun 30, 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 does a Medicare Case Manager do?

A Medicare Case Manager is a healthcare professional who coordinates and manages care for patients enrolled in Medicare. Their main responsibilities include assessing patient needs, developing care plans, facilitating communication between healthcare providers, and ensuring that patients receive appropriate, cost-effective services. They also help patients navigate the complexities of Medicare coverage and advocate for the best possible outcomes. Case managers work in settings such as hospitals, insurance companies, and home health agencies.

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 hardest part of being a case manager?

The hardest part of being a Medicare case manager is managing complex patient needs while coordinating with multiple healthcare providers and insurance companies. It requires strong organizational skills, attention to detail, and the ability to handle emotional or stressful situations when patients face health challenges or coverage issues.

What jobs pay 10,000 a month without a degree?

A Medicare Case Manager typically earns between $3,000 and $6,000 per month, which is below $10,000. High-paying jobs that can reach $10,000 a month without a degree include roles such as real estate brokers, sales managers, commercial pilots, or skilled trades like electricians and plumbers, often requiring experience, certifications, or licenses rather than a college degree.

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.

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 jobs pay 2000 a day?

Medicare Case Managers typically do not earn $2000 a day; their salaries are usually based on annual or hourly rates. High-paying roles in healthcare, such as specialized physicians or surgeons, can reach or exceed this daily income, especially with advanced certifications and experience. These roles often require extensive training, licensing, and work in high-demand environments.

What is a Medicare case manager?

A Medicare case manager is a healthcare professional who coordinates and manages Medicare beneficiaries' care plans, ensuring they receive appropriate services and benefits. They often work with healthcare providers, review medical records, and help patients navigate Medicare policies and coverage options.
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 June 2026, with employment types broken down into 2% As Needed, 36% Full Time, 45% Part Time, 15% Contract, and 2% Nights. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution, with an average salary of $47,743 per year, or $23 per hour.

CASE MANAGER

Forrest General Hospital

Hattiesburg, MS • On-site

$16.75 - $21.50/hr

Full-time

Posted 10 days ago

Job description

Job Summary:
  • The hospital case manager coordinates patient care, ensuring a smooth transition through the hospital stay and beyond. They assess patient needs, develop care plans, and facilitate communication between patients, families, and the healthcare team. Case managers also play a key role in discharge planning and utilization review, helping patients access appropriate resources and services.

Essential Functions:
  • The case manager plans, coordinates, develops, evaluates, and monitors the care of assigned group of patients to achieve quality cost-effective patient outcomes.
  • Completes & documents in the EMR, a discharge assessment on all assigned patients, which would include meeting with all new admissions to assess and discuss a proposed discharge plan and follow the progress of the discharge plan until discharged.
  • The Case Manager in the discharge planning role, will attend daily care management team meetings on their assigned unit.
  • Works collaboratively with interdisciplinary teams to identify services required to meet the patient and family needs throughout the continuum of care, while ensuring that appropriate resources are implemented in a timely manner.
  • Identifies and arranges appropriate post discharge services such as Home Health Care (HHC), Hospice, Skilled Nursing Facility (SNF), Inpatient Rehabilitation Facility (IRF), Long Term Acute Care Hospital (LTACH); Durable Medical Equipment (DME), or returns back to nursing home.
  • Communicates in a timely manner with the appropriate payer to initiate authorization for identified post-hospital services.
  • Demonstrates knowledge and skills to appropriately communicate and interact with the patients, families, and visitors while being sensitive to their cultural and religious beliefs.
  • Collaborates with physician, physician's office staff and registration staff and obtain the necessary information to support medical necessity and the medical review policies to assist in validating appropriateness of admission, services, and continued stay and, if necessary, issue letters of non-coverage as indicated.
  • Collaborates with registration staff and physician's office staff regarding physician orders for correct patient status assignment (Inpatient or Observation).
  • Issues Medicare hospital notices as indicated.
  • Collaborates with physician advisors, attending physician for questioned admissions to ensure set guidelines are followed for issued notices or an appeal of discharge.

  • For those patients at risk for readmission, the case manager will to identify and address the cause(s) for readmission to avoid for further readmission, when applicable.
  • The Case Manager in the Utilization Management (UM) role is involved in utilization review activities as defined by utilization management process.
  • The UM Case Manager performs admission reviews to ensure that assigned patients meet identified clinical criteria and are assigned to the correct admission status (Inpatient or Observation) and the UM nurse continues to monitor this throughout the hospital stay.
  • Performs timely level of care reviews on assigned patients and provides clinical updates to third-party payers in a timely fashion and obtains authorization from third party payers as indicated.
  • Consistently follow-up and update authorization/certification information on an ongoing basis.
  • The Case Manager will record, report and document denials and appeals on their assigned assigned group of patients and will follow-up with physician advisor and Denial Coordinator or other designated staff.
  • Functions as the central liaison between the Medicare QIO, review agencies, Business Services, Patient Financial Services, and other healthcare professionals affected by concurrent review, DRG assignment, the certification process, and discharge planning.
  • Is involved in utilization review activities as defined by the utilization management process. Participates on various committees/ task forces as needed.
  • Assists team leader with training of new staff or other tasks as needed. Assembles, analyzes, monitors, and tracks data for reporting as designated by the Director.

Performance Expectation:
  • Responds positively to change and has the ability to deal with multiple tasks
  • Accomplishes work in ways that maximize productivity.
  • Demonstrates the ability to manage daily workload.
  • Interacts effectively and builds respectful relationships with internal and external customers.
  • Adheres to various regulatory guidelines.
  • Advocates for and positively represent case management initiatives when working with others.
  • Demonstrate the ability to learn and follow various regulatory guidelines.
  • Demonstrates practices of all establish patient safety and infection control intervention
  • Follows facility policies and procedures as they apply

Qualifications:
Education/Skills
    • Graduate from an accredited, non-online RN program required.
    • Bachelor of Science in Nursing preferred.

Work Experience:
  • One to three years of experience in clinical nursing required.
  • One to three years Case Management and/or Utilization Management experience preferred.

Certification/Licensure-DUE UPON HIRE
  • Licensed RN able to practice within the State of MS

Mental Demands:
The successful candidate will be able to write and communicate professionally. The incumbent will be proficient in medical terminology, computer skills and use of basic office equipment such as copier and fax machine. The individual must have good time management skills and the ability to manage multiple tasks.
The successful candidate should have an understanding of the following:
• Clinical screening criteria, such as InterQual and Milliman Care Guidelines (MCG)
• Medicare's Prospective Payment System (PPS) & Outpatient Payment System (OPPS)
• Medicaid and other third-party payer general guidelines

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