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Medicare Case Manager Jobs (NOW HIRING)

AccordCare, Inc.

Clinical Case Manager

Orlando, FL · On-site

$75K/yr

Perform case management, oversight, and coordination of care for all skilled disciplines ... Minimum 1 year of Medicare OASIS experience (required) * Excellent time management and ...

Activa Home Health

Clinical Case Manager

Orlando, FL · On-site

$75K/yr

Perform case management, oversight, and coordination of care for all skilled disciplines ... Minimum 1 year of Medicare OASIS experience (required) * Excellent time management and ...

The Bell Minor Home

Director MDS - RN

Gainesville, GA · On-site

$34.50 - $41.75/hr

Conducts weekly Medicare/case management meetings to review plan of care. * Performs other tasks as assigned. * Conducts job responsibilities in accordance with the standards set out in the Company ...

South Shore Health

Case Manager

Weymouth, MA

$23.25 - $30/hr

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 ...

The Bell Minor Home

Director MDS - RN

Gainesville, GA

$34.50 - $41.75/hr

Conducts weekly Medicare/case management meetings to review plan of care. * Performs other tasks as assigned. * Conducts job responsibilities in accordance with the standards set out in the Company ...

South Shore Health

Case Manager

Weymouth, MA

$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 ...

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 ...

Forrest General Hospital

CASE MANAGER

Hattiesburg, MS

$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 ...

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 ...

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 ...

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 ...

Asherah Home & Palliative Care, Inc.

Be Seen First

Patient Case Manager

Burbank, CA · On-site

$3K - $5K/mo

Case Manager - Home Health Agency Job Title: Case Manager Department: Home Health Reports To ... Review and maintain compliance with Medicare, Medicaid, state, federal, and agency regulations.

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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 8, 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 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.
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 May 2026, with employment types broken down into 50% Full Time, 47% Part Time, and 3% Contract. 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 Coordinator

Case Manager Coordinator

Cibola General Hospital

Grants, NM • On-site

Full-time

Posted 22 days ago

Job description

Job Type
Full-time
Description
The Case Manager Coordinator is a key administrative support role within the Case Management team at our Critical Access Hospital. This position, best suited for a Certified Nursing Assistant (CNA), provides essential coordination, documentation, and authorization support to RN Case Managers.
By handling non-clinical administrative tasks, the Coordinator helps strengthen Medicare compliance, improve Utilization Review (UR) and reimbursement processes, enhance discharge planning efficiency, and reduce the administrative burden on licensed clinical staff. This role supports timely care transitions, minimizes authorization delays and denials, and contributes to better patient throughput and revenue cycle performance.
Key Responsibilities
Care Coordination & Discharge Planning Support
  • Provide direct administrative support to RN Case Managers in discharge planning and care coordination activities.
  • Assist with advance discharge planning, particularly for orthopedic surgical patients, including timely referrals, equipment orders, and post-acute services.
  • Coordinate referrals to community resources and post-acute providers, including:
  • Long-Term Care (LTC) facilities
  • Home Health Agencies
  • Visiting Nurse Services
  • Chronic Care Management (CCM) programs
  • Meals on Wheels
  • Specialty providers
  • Community and caregiver support services
  • Schedule and confirm follow-up appointments with primary care physicians and specialists.

Medicare & Regulatory Compliance
  • Issue and explain required Medicare notices, including the Important Message from Medicare (IMM) and Medicare Outpatient Observation Notice (MOON).
  • Ensure timely scanning, uploading, and documentation of notices and related records in the Electronic Health Record (EHR).
  • Maintain accurate patient records to support regulatory compliance and audit readiness.

Durable Medical Equipment (DME) Coordination
  • Order and coordinate delivery of prescribed DME.
  • Track DME arrangements to prevent discharge delays and ensure equipment is available when needed.

Utilization Review & Authorization Support
  • Assist RN Case Managers with payer authorization processes, including:
  • Initiating authorization requests
  • Gathering and compiling clinical documentation
  • Submitting or uploading clinical information per payer guidelines
  • Tracking authorization status and following up on pending requests
  • Communicating updates to the Case Management team
  • Maintain an authorization tracking log to monitor timely submission of initial and concurrent clinical reviews.
  • Assist in organizing documentation for denial reviews and first- and second-level appeals.
  • Support preparation of complete and accurate materials for payer submissions.

Administrative & Documentation Support
  • Prepare and transmit clinical documentation required for authorizations and appeals.
  • Scan, upload, and maintain all relevant patient documentation in the EHR.
  • Communicate effectively and professionally with patients, families, healthcare providers, and payers.
  • Perform general clerical and administrative tasks to support the Case Management team.
  • Complete other duties as assigned to enhance patient care management and hospital operations.

Scope of Role
The Case Manager Coordinator operates strictly in a support capacity. This role does not include performing clinical assessments, making medical necessity determinations, or conducting Utilization Review. All clinical reviews, level-of-care decisions, and final authorization approvals remain the responsibility of the licensed RN Case Manager.
Requirements
Required: Active Certified Nursing Assistant (CNA) license in the State of New Mexico. Strong organizational, time management, and multitasking skills. Excellent verbal and written communication and interpersonal skills. Proficiency with computers and document management systems. Preferred: 2-3 years of experience in a hospital setting (case management, discharge planning, or utilization review support preferred). Knowledge of Medicare documentation requirements (IMM, MOON). Experience with authorization processes and payer communication. Familiarity with Cerner EHR system. Work Environment Fast-paced acute care environment in a Critical Access Hospital. Frequent interaction with patients, families, interdisciplinary team members, providers, and external payers. Team-oriented setting with a strong focus on collaboration, compliance, and patient-centered care.

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