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Medicare Case Manager Jobs (NOW HIRING)

Helping Hands Of Springfield Inc

Case Manager

Springfield, IL · On-site

$48K - $51K/yr

  • Medical

  • Retirement

  • PTO

Director of Case Management Hours: 40 hours per week. Must be willing to work the occasional night ... Medicare, SNAP, and other benefits/services as needed * Distribute grant funded and/or donated ...

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 ...

InnovaCare

Case Manager

Jacksonville, FL · On-site

$18.50 - $23.75/hr

General knowledge of care (case) management practices, including familiarity with Medicare Advantage products, programs, and services. * Experience in establishing professional and collaborative ...

ATC Travelers A

Case Manager

Baltimore, MD · On-site

$19.75 - $25.50/hr

A Case Manager at Johns Hopkins Medicine facilitates the coordination of care for patients with ... Familiarity with Medicare, Medicaid, and private insurance regulations and reimbursement structures.

West Cecil Health Center Inc

Nurse Case Manager

Conowingo, MD · On-site

$80K - $94K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Nurse Case Manager will play a pivotal role in leading our Medicare Shared Savings Program efforts, promoting preventative wellness services and ensuring effective care coordination across the ...

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 ...

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 ...

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 ...

Gulfstream Staffing, Inc.

RN Case Manager

Vero Beach, FL · On-site

  • Retirement

  • PTO

Gulfstream Staffing has partnered with a medicare-certified Home Care organization that is experiencing a rapid growth phase. We are currently seeking candidates for a full-time RN Case Manager ...

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 ...

ATC Travelers A

Case Manager

Baltimore, MD

$19.75 - $25.50/hr

A Case Manager at Johns Hopkins Medicine facilitates the coordination of care for patients with ... Familiarity with Medicare, Medicaid, and private insurance regulations and reimbursement structures.

Healthbridge Staffing

Regional Case Manager

Louisville, KY · On-site

$90K - $105K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Now Hiring: Regional Case Manager - Midwest Region (TN/KY) Location: Midwest Region (Regional ... Monitor Medicare, Medicaid, and managed care trends while identifying opportunities to improve ...

ATC Travelers A

Case Manager

Baltimore, MD

$19.75 - $25.50/hr

A Case Manager at Johns Hopkins Medicine facilitates the coordination of care for patients with ... Familiarity with Medicare, Medicaid, and private insurance regulations and reimbursement structures.

Weber Human Services

Case Manager (SSW) - Aging

Ogden, UT · On-site

$24.75/hr

Aging Waiver Case Manager Medicaid Aging Waiver program is an in-home case management program. The ... State Health Insurance Information and Assistance Progam(SHIP)/Senior Medicare Patrol (SMP) Help ...

New

ATC Travelers A

Case Manager

Baltimore, MD · On-site

$19.75 - $25.50/hr

A Case Manager at Johns Hopkins Medicine facilitates the coordination of care for patients with ... Familiarity with Medicare, Medicaid, and private insurance regulations and reimbursement structures.

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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.
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What states have the most Medicare Case Manager jobs?

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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.

Access Case Manager

PIONEERS MEMORIAL HEALTHCARE DISTRICT

Brawley, CA • On-site

$68K - $93K/yr

Full-time

Re-posted 11 days ago

Job description

Summary:

The Access Case Manager evaluates the medical necessity for admission status. Assesses for transition Planning, and other measures for safe discharge to appropriate level of Care. Coordinates post hospital care when necessary

Essential Functions:

1. Initial patient screening

  • Identifies high risk patients through rounding and referrals from ED and admitting physicians, surgical services, nurses, hospitalists, ED patients and families, and other mechanisms as appropriate.
  • Uses ED tracking system, medical record, and demographic information to identify patients needing CM intervention

- Identify patients with frequent ED visits

- Identify patient returning to ED within 2 - 3 days

  • Document according to policy


2. Utilization review

  • Screens all patients who meet medical necessity
  • Works with the admitting physician and admissions to ensure admission to the appropriate status (ie: inpatient, observation, outpatient in a bed), and level of care (ICU, telemetry, etc.) using InterQual or approved criteria.
  • Educates community based and ED physicians and staff to understand admission status and appropriate patient placement and other regulatory requirements.
  • Reviews surgical schedules to ensure appropriate status for surgical patients.
  • Reviews all transfers-in for appropriateness of admission and intervenes as necessary.
  • Escalates to physician advisor when unable to resolve issues with the attending physician, according to policy and timeframes established.
  • Preadmission hospital issued notice of non-coverage (HINN) for Medicare patients per physician advisor determination and Medicare guidelines, when medical necessity criteria are not met.
  • Documents according to policy.
  • Case Managers who provide care to Joint Replacement patients will receive 1 hour of ortho/joint replacement specific education yearly.

3. Care coordination and patient flow

  • Initiates the Care Coordination Assessment for select patients.
  • Facilitates communication and information to all stakeholders.


OTHER RESPONSIBILITIES: As assigned


SUPERVISORY RESPONSIBILITIES: None.

EDUCATION, KNOWLEDGE, SKILLS, ABILITIES AND EXPERIENCE:

  1. Organization, analytical, writing, and interpersonal skills.
  2. Dependable, self-directed, and pleasant.
  3. Critical thinking, problem solving and deductive reasoning skills.
  4. Recent hospital experience preferably ICU, CCU, or strong minimum 3 years Med/Surg. Experience.
  5. Knowledge of Pathophysiology and Disease Process.
  6. Knowledge of Medicare, Medicaid, and Managed Care Health Plans.
  7. Experience in Hospital Case Management preferred.

LICENSES AND CERTIFICATIONS:

  1. Associate degree Nursing required.
  2. Bachelor’s degree in nursing preferred
  3. ACMA, CCM Preferred.
  4. Current American Heart Association BLS required.


AGE OF POPULATION SERVED:

Newborn Infant/Pediatric Adolescent Adult Geriatric All No Patient Care