Care Manager Job Description Template

Care Manager Overview

Care Managers work in home care agencies, health systems, managed care organizations, hospices, area agencies on aging, and community health programs. They report to a Director of Care Management, Chief Nursing Officer, or Medical Director depending on the organizational structure, and they typically manage caseloads ranging from 25 to 75 patients depending on care complexity and program model.

As a Care Manager, you will be responsible for conducting comprehensive clinical assessments, developing and coordinating individualized care plans, facilitating communication across multiple care providers, monitoring patient progress, and ensuring that patients and families have the education, resources, and support they need to manage health conditions effectively.

What sets this role apart from coordination-focused positions is its clinical depth and cross-system scope. Care Managers must navigate clinical complexity, social determinants of health, behavioral health factors, and insurance authorization requirements simultaneously. Success is measured by avoidable hospitalization rates, care plan adherence, patient satisfaction, and the cost-effectiveness of care under management.

Key Responsibilities

• Conduct comprehensive bio-psycho-social assessments of new patients to evaluate clinical needs, functional status, social support, behavioral health factors, and social determinants of health

• Develop individualized care plans in collaboration with patients, families, primary care physicians, specialists, and interdisciplinary care teams

• Coordinate care across multiple providers, facilities, and community services, ensuring seamless transitions and eliminating duplicative or conflicting care

• Monitor patient health status through regular check-ins, telehealth contacts, and home visits, adjusting care plans as clinical conditions evolve

• Provide patient and family education on disease management, medication adherence, treatment plans, and self-care strategies appropriate to each individual's health literacy

• Facilitate transitions of care from hospital to home, skilled nursing facility, or other post-acute settings, reducing readmission risk through proactive follow-up

• Identify and connect patients with community resources including transportation, nutrition programs, housing support, behavioral health services, and financial assistance

• Manage insurance authorization processes for home care services, durable medical equipment, and specialty referrals in compliance with payor requirements

• Document all care management activities in EHR systems, maintaining accurate, current records that support clinical decision-making and billing compliance

• Analyze patient data and population health metrics to identify high-risk individuals and prioritize proactive outreach and intervention

• Collaborate with behavioral health specialists, social workers, and community health workers to address the full spectrum of patient needs

• Maintain current knowledge of clinical practice guidelines, CMS regulations, accreditation standards, and payor contract requirements relevant to your patient population

Required Qualifications

• Bachelor's degree in Nursing, Social Work, Health Administration, or a related clinical field required; Master's degree preferred

• Active clinical license required: Registered Nurse (RN), Licensed Clinical Social Worker (LCSW), Licensed Professional Counselor (LPC), or equivalent

• Minimum 3 to 5 years of clinical or case management experience in a healthcare setting

• Working knowledge of Medicaid, Medicare, and managed care authorization and documentation requirements

• Experience with electronic health records (Epic, Cerner, or similar) and care management platforms

• Strong written and verbal communication skills for effective interaction with patients, families, physicians, and insurance contacts

• Valid driver's license for home visit and community-based care management assignments

• Ability to pass criminal background check, professional reference verification, and credential confirmation

Preferred Qualifications

• Certified Case Manager (CCM) through the Commission for Case Manager Certification

• Master of Social Work (MSW) or Master of Science in Nursing (MSN)

• Experience in a specific population focus such as geriatric care management, pediatric case management, behavioral health integration, or complex chronic disease management

• Telehealth platform experience and comfort with remote patient monitoring tools

• Bilingual language skills relevant to the patient population served

• Prior experience in managed care, ACO (Accountable Care Organization), or value-based care programs

Essential Skills and Competencies for Care Managers

Technical Skills

• Comprehensive clinical assessment and risk stratification

• Care plan development, implementation, and revision

• Insurance authorization and payor documentation

• EHR and care management platform proficiency

• Transitions of care and post-acute coordination

• Population health data analysis

• Community resource navigation and referral management

Soft Skills

• Complex problem-solving across clinical, social, behavioral, and logistical domains simultaneously

• Motivational interviewing and patient engagement skills that support behavior change

• Clear, compassionate communication with patients and families navigating difficult health circumstances

• Professional assertiveness in advocating for patients within healthcare and insurance systems

• Strong organizational capacity to manage high-complexity caseloads without losing responsiveness

• Emotional resilience in work that involves chronic illness, end-of-life situations, and systemic healthcare barriers

• Collaborative team orientation across diverse clinical and administrative stakeholders

Leadership Skills

• Interdisciplinary care team facilitation and stakeholder coordination

• Patient and family education and health coaching

• Quality improvement participation and metric-driven practice

• Mentorship of junior care coordinators or care aide staff

• Change management in evolving regulatory or organizational environments

Salary Range and Benefits for Care Managers

According to the Bureau of Labor Statistics and PayScale (2025), Care Managers earn a median annual salary of $68,000 to $85,000, with experienced Care Managers holding CCM certification or advanced clinical licenses in complex care settings earning $90,000 to $110,000 or more. Compensation varies by credential, specialization, employer type, and geographic market.

Top-Paying Areas: California, New York, New Jersey, Massachusetts, and Washington consistently rank highest for Care Manager compensation. Managed care organizations, health systems, and ACO programs typically offer stronger total compensation packages than home care agencies.

Benefits Package: Care Managers in health system or managed care settings typically receive comprehensive medical, dental, and vision insurance, 401(k) with employer matching, 20 to 25 days of paid time off annually, continuing education allowances, CCM exam support, mileage reimbursement for home and community visit roles, and access to professional development programs. Signing bonuses ranging from $2,000 to $7,500 are increasingly common in competitive hiring markets. Performance bonuses tied to caseload outcome metrics are common in value-based care and managed care settings.

Frequently Asked Questions About Care Managers

Q: What does a Care Manager do?

A: A Care Manager conducts comprehensive clinical assessments, develops individualized care plans, coordinates care across multiple providers and services, and monitors patient health outcomes to ensure safe, efficient, and cost-effective care. They serve as the primary advocate and point of contact for patients and families navigating complex health situations, facilitating transitions between care settings, securing community resources, and managing insurance authorizations. Care Managers work across home care, managed care, health systems, hospice, and community health programs.

Q: What qualifications do you need to be a Care Manager?

A: Care Manager positions typically require a Bachelor's degree in Nursing, Social Work, or a related clinical field, plus an active clinical license such as RN, LCSW, or LPC. Minimum 3 to 5 years of clinical or case management experience is standard. The CCM (Certified Case Manager) credential from the Commission for Case Manager Certification is strongly preferred and often required for managed care or health system roles.

Q: How much does a Care Manager make?

A: According to BLS and PayScale data (2025), Care Managers earn a median annual salary of $68,000 to $85,000. Experienced Care Managers with CCM certification, advanced clinical degrees, or specializations in complex population health programs earn $90,000 to $110,000 or more. Managed care and ACO settings typically offer the highest total compensation packages in this field.

Q: What skills are required for a Care Manager?

A: Care Managers need strong clinical assessment skills, care plan development expertise, insurance authorization knowledge, EHR proficiency, transitions of care competency, and population health data literacy. Critical soft skills include motivational interviewing, complex problem-solving, patient advocacy, collaborative team facilitation, and the emotional resilience required for sustained high-complexity caseload management.

Q: What is the difference between a Care Manager and a Case Manager?

A: The terms are frequently used interchangeably, but in formal contexts, Case Manager is often the broader, older title while Care Manager reflects a more contemporary model that emphasizes proactive health management, care coordination across systems, and social determinants of health. In managed care and value-based programs, Care Manager typically signals a more clinically intensive and population health-oriented scope.

Q: What certifications are most valuable for Care Managers?

A: The CCM (Certified Case Manager) credential is the most widely recognized and sought-after certification across health systems, managed care, hospice, and home care. The ACM (Accredited Case Manager) credential from the American Case Management Association is particularly valued in hospital and acute care settings. For geriatric-focused Care Managers, the CMC from the Aging Life Care Association provides specialized credentialing.