Are Case Managers Exempt From Overtime?

Often not. Most salaried case managers do the employer's core work by following its assessments, workflows and approval rules, and that is not the independent judgment an overtime exemption requires.

Your employer calls you “exempt.” That word is a label, not a ruling. Under the Fair Labor Standards Act, overtime — time and a half for every hour over 40 in a week — is the default, and the employer has to prove an exemption fits. Your title doesn't decide it. Your salary alone doesn't decide it. What you actually do all day decides it.

The three tests

An employer must pass all three. Fail one, and you are owed overtime.

1. Salary basis. You must be paid a fixed salary that isn't cut for the quality or quantity of your work. Paid by the hour? The administrative exemption doesn't apply. See salary vs. hourly.

2. Salary level. $684 a week, or $35,568 a year. The 2024 rule was vacated (E.D. Tex. Nov. 15, 2024), and the Department of Labor formally reinstated the 2019 figures effective May 15, 2026.

3. Duties. This is where most case manager exemptions fall apart.

• The administrative exemption, 29 C.F.R. §§ 541.200–.203: your primary duty must be office work directly related to running the employer's business, and it must include “the exercise of discretion and independent judgment with respect to matters of significance.”
• The learned professional exemption, 29 C.F.R. §§ 541.300–.301: your primary duty must require advanced knowledge in a field of science or learning, customarily acquired by a prolonged course of “specialized intellectual instruction.” A degree you happen to have isn't enough; the job has to require it and use it.
• RN case managers: the Department of Labor's Fact Sheet #17N says registered nurses “generally meet the duties requirements” of the professional exemption, but only if paid on a salary basis. It also says “Registered nurses who are paid on an hourly basis should receive overtime pay,” and that LPNs “generally do not qualify as exempt.”

Most case managers clear the salary tests. The fight is over duties.

Why the administrative exemption usually doesn't fit

The administrative exemption covers people who run the business: finance, HR, compliance, policy. It does not cover the people who deliver the product. For a health plan, a hospital or a human services agency, case management is the product. You assess members, build care plans from templates, line up services and document every step. That is production work.

Discretion is the other problem. Under the regulations, discretion and independent judgment “must be more than the use of skill in applying well-established techniques, procedures or specific standards described in manuals or other sources.” 29 C.F.R. § 541.202(e). If your assessments are scripted, your care plans come from a template, and anything out of the ordinary goes up to a supervisor or medical director, you are following someone else's judgment.

What your day looks like

Usually points to non-exempt, meaning you are owed overtime

• Applying InterQual, MCG or program eligibility criteria
• Running scripted or required assessments and screenings
• Building care plans from templates and set goals
• Documenting in the care management system to meet audit and contact standards
• Scheduling visits and calls; tracking caseload contacts
• Making referrals and connecting members to providers and community services
• Escalating anything outside the guidelines to a medical director or supervisor

Can point toward exempt

• Writing or setting the policies and criteria others follow
• Making binding decisions on significant matters without a supervisor or medical director signing off
• Deviating from company policy on your own authority
• Supervising two or more full-time employees as your primary duty, under the executive exemption
• Negotiating and binding the company on contracts or budgets

If most of your week is in the first list, your employer has a problem, not you.

The title doesn't matter

Employers use dozens of names for the same job: Case Manager, Care Manager, RN Case Manager, Health Manager, Care Coordinator, Field Case Manager, Behavioral Health Case Manager, Child Welfare Case Manager, QIDP. Under the FLSA the work controls, not the name on your badge. If you assess needs, build care plans, coordinate services and monitor delivery under company rules, you are likely owed overtime. Coordinators should also see our care coordinators page; so should behavioral health case managers, child welfare caseworkers and service and support coordinators.

This happens across managed care, hospitals, behavioral health, child welfare, disability services, home health and community health centers. Wherever there is a caseload, there is a chance it is misclassified. Nonprofit employers are covered too — see nonprofit case managers.

Our work for case managers

Brewer v. Molina Healthcare, Inc., No. 1:16-cv-09523, and Gongora-Ownby v. Molina Healthcare, Inc., No. 1:16-cv-11346 (N.D. Ill.). More than 1,100 salaried Case Managers and Health Managers alleged they assessed members, built care plans and connected enrollees with providers using company-prescribed workflows, and were paid no overtime. Both cases were resolved together in one settlement approved June 12, 2018. Siegel Law Group was lead counsel. Brewer · Gongora-Ownby

Kelly v. Evolent Health LLC, No. 1:19-cv-00500 (N.D. Ill.). Salaried care management employees, including Case Managers and Utilization Management Nurses. The court conditionally certified the collective, and the case settled the claims of about 69 opt-ins. Siegel Law Group was lead counsel. Read the ruling · Read about the settlement

Barbee v. NaviHealth, Inc., No. 3:19-cv-00119 (M.D. Tenn.). Salaried post-acute care management employees alleged they followed established guidelines and protocols and worked more than 40 hours a week without overtime. The case settled the claims of more than 1,100 employees on an FLSA collective and Rule 23 basis, with final approval on September 21, 2020. The court appointed Jack Siegel, among other counsel, as class counsel. Read about the settlement

The same fight runs through utilization review, and through the New Mexico managed care cases under New Mexico wage law. A longer list of the companies is on our employers we've sued page.

Jack Siegel has filed overtime cases in 25 federal districts across 20 states, and has obtained 50+ class and collective certifications in 20 federal judicial districts across 15 states, as lead counsel on the firm's cases. The firm has recovered more than $100 million for workers, and it has never represented an employer in a wage case.

Prior results do not guarantee or predict a similar outcome in any future matter. These are results in other people's cases. Each case is decided on its own facts, its own record and its own procedural posture. Conditional certification and class certification are procedural rulings about whether a case may proceed as a group action; they are not findings of liability and they are not an award of money. This website contains attorney advertising.

What you can recover

If you were misclassified, the FLSA allows back pay for unpaid overtime, an equal amount again in liquidated damages, and attorney's fees and costs paid by the employer. Many states add their own overtime claims on top. What period a claim can reach back over is its own question of law, covered on our statute of limitations page, and group claims are explained on our collective and class actions page. Working in Texas? See Texas case managers and UR nurses.

Federal law also bars your employer from retaliating against you for asking about overtime. See retaliation protections.

Questions case managers ask us

I'm salaried. Doesn't that mean I can't get overtime?

No. A salary is only one of three tests. If your duties don't meet an exemption, you are owed overtime even on a salary.

I'm an RN case manager. Doesn't my license make me exempt?

Not automatically. Fact Sheet #17N says RNs generally meet the professional duties test, but the exemption still requires a salary basis, and hourly RNs are owed overtime. The question is what your job actually requires you to do. If it is applying criteria and templates, that is the fight we bring.

My job title has “manager” in it. Am I exempt?

Not because of the title. The executive exemption requires managing a department and regularly directing two or more full-time employees. Managing a caseload of members is not managing people.

I can't prove my hours. Can I still bring a claim?

Yes. The employer is the one required to keep time records. When it doesn't, courts accept a worker's reasonable estimate. Logins, emails and phone records help, and a record you keep yourself on your own device helps more.

Will this cost me anything?

You pay no fee and no costs unless we recover. We advance the costs of the case. If there is a recovery, those costs are repaid out of it.

Where to file a complaint with an agency

• FLSA overtime rules, U.S. DOL Wage and Hour Division
• File a complaint with the Wage and Hour Division
• DOL Fact Sheet #17N, nurses and the overtime exemptions
• Administrative exemption regulations, 29 C.F.R. §§ 541.200–541.204
• Professional exemption and nurses, 29 C.F.R. § 541.301

Sources

1. 29 U.S.C. § 207(a)(1) (overtime at one and one-half times the regular rate for hours over 40); 29 U.S.C. § 216(b) (liquidated damages, attorney's fees and costs); 29 U.S.C. § 215(a)(3) (retaliation).
2. 29 C.F.R. § 541.200(a) (the three elements of the administrative exemption, including “the exercise of discretion and independent judgment with respect to matters of significance”); 29 C.F.R. §§ 541.201–.203.
3. 29 C.F.R. § 541.202(e) (discretion and independent judgment “must be more than the use of skill in applying well-established techniques, procedures or specific standards described in manuals or other sources”); see also 29 C.F.R. § 541.704 (use of manuals).
4. 29 C.F.R. §§ 541.300–.301 (learned professional exemption; advanced knowledge in a field of science or learning customarily acquired by a prolonged course of “specialized intellectual instruction”).
5. U.S. Dep't of Labor, Wage & Hour Div., Fact Sheet #17N (registered nurses “generally meet the duties requirements” of the professional exemption; “Registered nurses who are paid on an hourly basis should receive overtime pay”; licensed practical nurses “generally do not qualify as exempt”).
6. 29 C.F.R. § 541.600(a) ($684 per week), as restored by 91 Fed. Reg. 27835 (May 15, 2026), after the 2024 salary-threshold rule was vacated in Texas v. U.S. Department of Labor (E.D. Tex. Nov. 15, 2024).
7. 29 C.F.R. § 541.100(a) (executive exemption; management of a customarily recognized department and customarily and regularly directing the work of two or more other employees).
8. 29 U.S.C. § 211(c) and 29 C.F.R. § 516.2 (the employer's duty to keep hours records); Anderson v. Mt. Clemens Pottery Co., 328 U.S. 680 (1946) (where the employer's records are inaccurate or inadequate, an employee may prove the amount and extent of the work as a matter of just and reasonable inference).
9. Brewer v. Molina Healthcare, Inc., No. 1:16-cv-09523 (N.D. Ill.), and Gongora-Ownby v. Molina Healthcare, Inc., No. 1:16-cv-11346 (N.D. Ill.) (settlement of both cases approved June 12, 2018).
10. Kelly v. Evolent Health LLC, No. 1:19-cv-00500 (N.D. Ill.) (collective conditionally certified; settlement of the claims of about 69 opt-ins).
11. Barbee v. NaviHealth, Inc., No. 3:19-cv-00119 (M.D. Tenn.) (FLSA collective and Rule 23 settlement for more than 1,100 employees; final approval September 21, 2020).

You pay no fee and no costs unless we recover. Call or text (214) 790-4454, email [email protected], or contact us.

Attorney responsible: Jack L. Siegel, Dallas, Texas.