Mid Level Medical Case Manager Jobs
Mid level medical case manager jobs go to professionals ready to own complex caseloads, coordinate across care teams with minimal supervision, and mentor newer staff through challenging patient situations. Openings run across Insurance, Healthcare & Medical Services, and Manufacturing, with 100% remote or hybrid availability, and employers like AmTrust Financial, Owens Corning, and Highmark Health hiring at this level now.
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Showing 5 of 10+ Mid Level Medical Case Manager jobs
JOB SUMMARY
This is a full-time position requiring frequent travel within the assigned territory in DE.
This job is responsible for providing comprehensive case management services to members, ensuring quality, cost-effective care delivery, and promoting optimal health outcomes. The Case Manager assesses member needs, develops and implements care plans, coordinates services, and monitors progress, while containing the cost of health care services. The incumbent will assist in containing the cost of health care services by detecting, resolving and preventing improper utilization of member benefits.
ESSENTIAL RESPONSIBILITIES
- Manage a caseload of members with moderate complexity health needs.
- Assess members’ health status, needs, and available resources.
- Develop individualized care plans in collaboration with members, physicians, and other healthcare providers.
- Implement and coordinate care plans, ensuring access to appropriate services and resources.
- Develop and implement care plans with minimal guidance.
- Coordinate referrals to specialists and community resources.
- Monitor member progress toward goals and adjust care plans as needed.
- Evaluate the effectiveness of interventions and services.
- Act as an advocate and liaison to meet a member's individual health care needs by assessing, planning, implementing, coordinating, monitoring and evaluating options and services. This is accomplished by using communication and available resources to promote quality, cost-effective outcomes in accordance with available contract benefits.
- Work collaboratively and communicate clearly and professionally with physicians, providers, co-workers and other members of the health care team to carry out the established plan of care.
- Ensure all activities are documented and conducted in compliance with applicable business process requirements, company policies, regulatory requirements and accreditation standards.
- Identify areas for potential cost savings, quality improvement and workflow efficiencies.
- Other duties as assigned or requested.
Experience
Required
3 years of experience in any combination of clinical, case/utilization management, and/or disease condition management experience, or provider operations and/or health insurance experience with RN licensure or a Master’s degree OR; 5 years’ experience with a Bachelor’s in Social Work
Preferred
- Pediatric experience
- Medicaid managed care and/or Medicare experience
- Experience working with the healthcare needs of diverse populations
- Experience demonstrating understanding of importance of culture competency in addressing targeted populations
SKILLS
- Strong assessment and care planning skills.
- Ability to work independently and as part of a team.
- Proficiency in using Microsoft office suite, case management software and electronic health records.
- Understanding of healthcare systems and case management principles
- Bilingual English/Spanish language skills preferred
Education
Required
Bachelor’s degree in nursing or RN licensure or Master’s degree in Social Work, Counseling, or related field OR Bachelor’s degree in Social Work
Preferred
None
LICENSES or CERTIFICATIONS
Required
Licensed Social Worker (LSW)-Non-Specific - State (OR) Licensed Professional Counselor (LPC) - Non-Specific State (OR) Licensed Bachelors Social Worker (LBSW) (OR) Licensed Clinical Social Worker (LCSW) - Non-Specific (OR) Licensed Master Social Worker (LMSW) Non-Specific (OR) Licensed Graduate Social Worker (LGSW) (OR) Licensed Certified Social Worker (LCSW) (OR) Current State RN licensure OR Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC). Incumbents in the role prior to 1/1/25 who are not currently licensed must obtain licensure by 12/31/27.
Preferred
Certified Case Manager (CCM)
Language (Other than English):
None
Travel Required:
0% - 25%
PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS
Position Type
Office-Based or Remote Position
Physical work site required
Occasionally
Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
Pay Range Minimum:
$72,700.00
Pay Range Maximum:
$116,600.00
Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
California Consumer Privacy Act Employees, Contractors, and Applicants Notice
JOB SUMMARY
This is a full-time position requiring frequent travel within the assigned territory in DE.
This job is responsible for providing comprehensive case management services to members, ensuring quality, cost-effective care delivery, and promoting optimal health outcomes. The Case Manager assesses member needs, develops and implements care plans, coordinates services, and monitors progress, while containing the cost of health care services. The incumbent will assist in containing the cost of health care services by detecting, resolving and preventing improper utilization of member benefits.
ESSENTIAL RESPONSIBILITIES
- Manage a caseload of members with moderate complexity health needs.
- Assess members’ health status, needs, and available resources.
- Develop individualized care plans in collaboration with members, physicians, and other healthcare providers.
- Implement and coordinate care plans, ensuring access to appropriate services and resources.
- Develop and implement care plans with minimal guidance.
- Coordinate referrals to specialists and community resources.
- Monitor member progress toward goals and adjust care plans as needed.
- Evaluate the effectiveness of interventions and services.
- Act as an advocate and liaison to meet a member's individual health care needs by assessing, planning, implementing, coordinating, monitoring and evaluating options and services. This is accomplished by using communication and available resources to promote quality, cost-effective outcomes in accordance with available contract benefits.
- Work collaboratively and communicate clearly and professionally with physicians, providers, co-workers and other members of the health care team to carry out the established plan of care.
- Ensure all activities are documented and conducted in compliance with applicable business process requirements, company policies, regulatory requirements and accreditation standards.
- Identify areas for potential cost savings, quality improvement and workflow efficiencies.
- Other duties as assigned or requested.
Experience
Required
3 years of experience in any combination of clinical, case/utilization management, and/or disease condition management experience, or provider operations and/or health insurance experience with RN licensure or a Master’s degree OR; 5 years’ experience with a Bachelor’s in Social Work
Preferred
- Pediatric experience
- Medicaid managed care and/or Medicare experience
- Experience working with the healthcare needs of diverse populations
- Experience demonstrating understanding of importance of culture competency in addressing targeted populations
SKILLS
- Strong assessment and care planning skills.
- Ability to work independently and as part of a team.
- Proficiency in using Microsoft office suite, case management software and electronic health records.
- Understanding of healthcare systems and case management principles
- Bilingual English/Spanish language skills preferred
Education
Required
Bachelor’s degree in nursing or RN licensure or Master’s degree in Social Work, Counseling, or related field OR Bachelor’s degree in Social Work
Preferred
None
LICENSES or CERTIFICATIONS
Required
Licensed Social Worker (LSW)-Non-Specific - State (OR) Licensed Professional Counselor (LPC) - Non-Specific State (OR) Licensed Bachelors Social Worker (LBSW) (OR) Licensed Clinical Social Worker (LCSW) - Non-Specific (OR) Licensed Master Social Worker (LMSW) Non-Specific (OR) Licensed Graduate Social Worker (LGSW) (OR) Licensed Certified Social Worker (LCSW) (OR) Current State RN licensure OR Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC). Incumbents in the role prior to 1/1/25 who are not currently licensed must obtain licensure by 12/31/27.
Preferred
Certified Case Manager (CCM)
Language (Other than English):
None
Travel Required:
0% - 25%
PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS
Position Type
Office-Based or Remote Position
Physical work site required
Occasionally
Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
Pay Range Minimum:
$72,700.00
Pay Range Maximum:
$116,600.00
Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
California Consumer Privacy Act Employees, Contractors, and Applicants Notice
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Mid Level Medical Case Manager Jobs: Frequently Asked Questions
How do I get a mid level medical case manager job?
Position your application around concrete outcomes: caseload size you managed independently, care transitions you owned, and protocols you helped improve. Highlight your clinical assessment skills, familiarity with utilization management, and any cross-functional coordination you led. Certifications like CCM or ACM signal readiness for this level and help your application stand out to hiring managers looking for someone who can step in with minimal ramp-up.
Which companies hire mid level medical case managers?
Companies hiring mid level medical case managers right now include AmTrust Financial, Owens Corning, and Highmark Health, based on current listings on Migrate Mate as of November 2026. At this level, hiring comes primarily from health systems, managed care organizations, insurance carriers, and specialty case management firms that need professionals who can carry full caseloads and work with limited oversight.
Are there remote mid level medical case manager jobs?
Yes, remote and hybrid options are well established at this experience level. About 100% of mid level medical case manager openings are remote or hybrid as of November 2026, reflecting how health plans and managed care employers have built distributed case management teams. Telephonic and virtual case management roles are especially common at this stage, often covering regional or national patient populations.
How do I move up to a mid level medical case manager role?
Moving into mid level requires building a record of independent case ownership rather than assisted work. Focus on deepening your clinical knowledge in one or two settings, taking on more complex cases, and demonstrating measurable impact like reduced readmission rates or improved care plan adherence. Earning a recognized certification, such as the CCM, and volunteering to mentor newer colleagues signals to employers that you are operating above an entry level baseline.
Which industries hire the most mid level medical case managers?
Mid Level medical case manager roles concentrate in Insurance, Healthcare & Medical Services, and Manufacturing, based on current listings on Migrate Mate as of November 2026. These sectors drive mid level hiring because they manage large, ongoing patient populations that require experienced coordinators who can balance clinical judgment, payer requirements, and care team communication without constant supervision.