Case manager job description template: RN or social work seat, CCM and ACM lines, caseload and discharge planning rules
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A case manager job description should first say which case manager you mean: a hospital RN doing utilization review and discharge planning, a social worker coordinating services in the community, a health plan nurse managing members by phone, or a workers' compensation case manager. Then it should name the license the seat needs, the caseload, the credentials you accept and the pay. As of October 2026, the main national credentials are the CCM from the Commission for Case Manager Certification and ACMA's ACM-RN and ACM-SW; ANCC's nursing case management certification is moving to renewal only. BLS does not publish a separate case manager occupation.
Below are the case manager seats, a copy-ready template, the license, credential, hospital rule and overtime lines with sources, screening questions and scorecard rows, and common mistakes. For the call itself, use the case manager screening questions.
Not legal advice. The credential, discharge planning and overtime points below were checked against the Commission for Case Manager Certification's July 2026 guide, ACMA, ANCC, 42 CFR 482.43 on Cornell's Legal Information Institute, the Department of Labor and BLS as of October 2026. Nursing and social work licensure is set by each state; verify the license with the job state's board.
Name the seat: which case manager are you hiring?
| Seat | What the day looks like | Must-have that separates it |
|---|---|---|
| Hospital RN case manager | Utilization review, level-of-care decisions, discharge planning, avoidable-day follow-up | RN license; the criteria set you use; a hospital caseload carried recently |
| Hospital social work case manager | Psychosocial assessments, placement, family meetings, community resources | Social work license or degree as your state and hospital require; post-acute placement experience |
| Health plan care manager | Telephonic outreach to members, transitions of care, care plans, often remote | Payer-side care management and member contact targets |
| Community or behavioral health case manager | Housing, benefits, appointments and crisis linkage, field visits | Field work with the population; driver's license if visits are by car |
| Workers' compensation or disability case manager | Return-to-work plans, communication with adjusters, employers and treating providers | RN or CCM, with return-to-work cases closed |
Then settle the numbers with the director: caseload in the setting's terms (patients per day, members per month, units covered), the share of utilization review, weekend and holiday rotation, field visits or remote days, and the documentation system. A hospital seat with "a 20-patient unit assignment, utilization review and discharge planning" (an invented example) attracts a different candidate than "manage a caseload."
The case manager job description template
[RN / Social Work] Case Manager — [Hospital Unit / Emergency
Department / Health Plan / Community Program / Workers' Comp],
[Full-Time / Part-Time / PRN]
[Organization], [city, state] — [On-site / Hybrid / Remote within:
states / Field: area]
Pay: $[min]–$[max] per [year / hour], plus [weekend differential
$N, certification differential $N, mileage $N per mile].
[Benefits summary, if required.] [Exempt / Nonexempt, after review.]
SUMMARY
You will [cover N beds on (units) / carry about N members / carry
about N clients] in [setting], [with / without] utilization review.
You will work with [physicians, nurses, social workers, payers,
community agencies] and report to [director of case management].
Schedule: [days, hours], [every Nth weekend], [N field visits a
week across (area)].
WHAT YOU WILL DO
- Assess patients' or members' needs and risks and build a plan
with them and their families.
- [Hospital: review admissions and continued stays against
(criteria set), and work with physicians on level of care.]
- Plan discharges and transitions: post-acute referrals, services,
equipment and follow-up appointments, offering patients a choice
of providers as federal rules require.
- Coordinate with payers on authorizations and benefits.
- Document in [system] within [N hours] of each contact.
- Track avoidable days, readmissions or [program measures].
YOU MUST HAVE
- [Active (state) RN license or multistate license] / [(State)
social work license or a BSW or MSW, as the role requires].
- [N] years of [hospital / payer / community] experience, [N] of
them in case management [or a training plan we provide].
- [Driver's license and insurance, for field visits.]
- Ability to [walk between units and stand for patient and family
meetings / work at a computer and phone for most of the day],
with or without reasonable accommodation.
NICE TO HAVE
- CCM, ACM-RN or ACM-SW.
- Experience with [criteria set], [EHR], [payer portals].
If you meet the must-haves and none of these, please apply.
FIXED CONDITIONS
- Offer subject to license verification and [background check]
as permitted by law.
[EEO STATEMENT]
Need an adjustment to apply or interview? Contact [address].Licenses, certifications, hospital rules and classification
What the work is. The Commission for Case Manager Certification defines case management as a process that assesses, plans, implements, coordinates, monitors and evaluates to improve outcomes, experiences and value. The license behind the seat comes from the discipline: an RN license for nurse case managers, a state social work license or degree for social work seats. BLS covers both professions, in its registered nurses and social workers profiles (both last modified August 27, 2026), but not case managers as a separate occupation.
CCM. The Commission's July 2026 certification guide requires a current, active and unrestricted license or certification in a health or human services discipline, or, where the discipline needs no license, a bachelor's or graduate degree in a health or human services field. Applicants also need one of three experience categories: 12 months of full-time case management supervised by a CCM, 24 months of full-time case management, or 12 months supervising case managers. Experience in the past five years counts; internships, practicums and volunteer work do not; the certification is valid for five years. The Commission keeps a public database of certificants for verification.
ACM. ACMA's ACM program has two credentials, ACM-RN for registered nurses and ACM-SW for social workers, for case managers in health delivery systems; applicants need a nursing license, or a social work degree or license, plus at least 2,080 hours of supervised, paid case management work in a health delivery system (ACMA). It fits hospital seats closely.
ANCC. ANCC says its Nursing Case Management certification (CMGT-BC) is transitioning to renewal only: it accepts applications through December 31, 2026, and the exams are retired after December 31, 2027 (ANCC). Accept existing CMGT-BC holders, but do not tell new candidates to earn it.
Hospital discharge planning rules. In Medicare-participating hospitals, discharge planning evaluations and plans must be developed by, or under the supervision of, a registered nurse, social worker or other appropriately qualified personnel; patients who need home health, skilled nursing, inpatient rehabilitation or long-term care hospital services get a list of available Medicare-participating providers, are told they may choose, and the hospital must not limit the qualified providers available (42 CFR 482.43(a) and (d)). Putting "offering patients a choice of providers" in the duties tells candidates you run the process correctly.
Exempt or nonexempt. The Department of Labor says RNs registered by their state board generally meet the learned professional duties test and may be exempt if paid on a salary basis of at least $684 a week, while RNs paid hourly should receive overtime (DOL Fact Sheet 17N). For social work and other case managers, the learned professional exemption depends on whether the job requires an advanced, specialized degree and on the duties (DOL Fact Sheet 17D); a seat that accepts any bachelor's degree is the one to review, and so is any case manager paid by the hour.
Physical requirements. Hospital seats involve walking between units and long days on a computer and phone; community seats involve driving and home visits. Describe the real conditions and add an accommodation line.
Pay. With no case manager occupation, use the profession's figure as a national reference only: registered nurses had a national median annual wage of $97,550 in May 2025 (BLS), and healthcare social workers $67,880 (BLS). Post your own range and differentials, and check pay transparency laws by state.
From must-haves to screening questions and scorecard rows
| Must-have | Screening question | Scorecard competency | Evidence of a strong answer |
|---|---|---|---|
| License and credential | "Which license do you hold, in which states, and do you hold the CCM or ACM?" | Not scored: verified with the board and issuer | Exact titles, states and dates that match the verification |
| Caseload | "What was your caseload, in your setting's terms, and how did you decide who got your time first?" | Prioritization | A number close to yours and a risk-based method |
| Utilization review (hospital seats) | "Which criteria set did you use, and what did you do when a stay no longer met it?" | Level-of-care judgment | Names the criteria, talks to the physician, escalates through physician advisor review |
| Discharge planning | "A patient needs a skilled nursing facility and the family wants one that has not accepted them. What do you do?" | Patient choice and transitions | Offers the list, respects choice, works alternatives, documents |
| Payer work | "Tell me about an authorization that was denied. What happened next?" | Advocacy | Peer-to-peer or appeal, a backup plan, the outcome |
The full screen, including the hospital rule questions, is in the case manager screening questions; for sourcing, see Boolean search strings for case managers. If the seat is really a licensed social work role, start from the social worker job description template and the interview guide for social workers; for the RN license lines, see the registered nurse job description template.
Common mistakes in case manager job descriptions
"RN or social worker" with no further detail
Both can be right, but utilization review and psychosocial work need different people. Say which work goes with which license.
No caseload
Caseload tells a candidate whether they can do the work well. Give it in the setting's terms.
Requiring a credential they cannot have yet
The CCM needs at least 12 months of case management experience. "CCM required" for an entry seat excludes everyone you could train; prefer it or allow time after hire.
Telling new hires to earn a retiring credential
ANCC's CMGT-BC is moving to renewal only. Point new candidates to the CCM or ACM instead.
Hiding weekends, field work or remote rules
Hospital rotations, home visits and the states a remote case manager may live in all belong in the posting.
Before you publish
- Setting, license, caseload and the share of utilization review are in the title and summary.
- Credentials accepted are listed, with CCM experience rules respected.
- Hospital seats mention patient choice of post-acute providers.
- Exempt status is reviewed by license and pay basis.
- The pay range, differentials, EEO statement and accommodation contact close the posting.
Questions people ask
What should a case manager job description include?
Name the setting (hospital, emergency department, health plan, community program or workers' compensation), the license the seat needs (RN, social work license or degree), the caseload in the setting's terms, whether the role includes utilization review, the credentials you accept such as CCM or ACM, field work or remote work, and the pay range with exempt status reviewed.
Should a case manager be an RN or a social worker?
It depends on the work. Utilization review and clinically heavy seats usually require an RN, while psychosocial, community and behavioral health case management often prefer a social work license or degree. In Medicare-participating hospitals, the federal rule says discharge planning evaluations and plans are developed by, or under the supervision of, a registered nurse, social worker or other appropriately qualified personnel.
What are the requirements for the CCM certification?
As of the Commission for Case Manager Certification's July 2026 guide, applicants need a current, active and unrestricted license or certification in a health or human services discipline, or a qualifying bachelor's or graduate degree where licensure is not required, plus 12 months of full-time case management supervised by a CCM, 24 months of full-time case management, or 12 months supervising case managers. Only the past five years count, and the certification is valid for five years.
Are case managers exempt from overtime?
It depends on license, pay and duties. The Department of Labor says RNs registered by their state board generally meet the learned professional duties test and may be exempt if paid a salary of at least $684 a week, while hourly RNs should receive overtime. For social work and other case managers, the answer depends on the degree the job requires and the duties, so review each title.