This study was conducted to identify effects of Medicaid Case Manager's communication competence and stress on their job satisfaction. Methods: The current work is descriptive research, and the participants were 154 medicaid case managers. Data were collected between May and July, 2017 through Embrain, a specialized research organization. The data were analyzed using independent t-test, ANOVA, and multiple regression. Results: The mean communication competence of the medicaid case managers was 3.61, stress 1.76, and their job satisfaction 2.74. Age and average monthly compensation brought significant differences in their job satisfaction. Their communication competence was correlated with stress (r=-.35, p<.001), but not with their job satisfaction. The stress was the most influential factor in job satisfaction (β=-.45). Conclusion: The results of this work show that the medicaid case managers' communication competence was not an influence factor of their job satisfaction, which is different from implications from the previous studies and needs confirmation through future research. In addition the results of this study also suggest that stress management can be a useful approach to the improvement of medicaid case managers' job satisfaction.