Under the general direction of the Manager of Case Management, this individual will manage a caseload of high-risk, high-cost members by conducting comprehensive assessments, developing individualized care plans, coordinating services across providers, and promoting disease-specific education and self-management. This role is ideal for those that enjoy care coordination, population health, disease management, and member advocacy rather than bedside care. The Nurse Case Manager serves as a critical liaison between members, providers, behavioral health resources, and community organizations to improve health outcomes and reduce barriers to care.
Key Responsibilities:
Clinical Case Management
- Conduct telephonic assessments of high-risk, high-cost members.
- Identify medical, behavioral health, and social determinants impacting health outcomes.
- Develop individualized care plans, interventions, and measurable goals.
- Monitor member progress and revise care plans when necessary.
Care Coordination
- Coordinate services among primary care providers, specialists, behavioral health providers, and community resources.
- Facilitate communication between members, families, and healthcare teams.
- Support transitions of care and ensure continuity of treatment.
Disease Management & Member Education
- Educate members on chronic conditions and treatment plans.
- Promote preventive care and healthy lifestyle changes.
- Provide guidance around medications, nutrition, exercise, and symptom management.
- Support members in meeting self-management goals.
Compliance & Documentation
- Maintain accurate documentation and care management records.
- Ensure adherence to regulatory and quality standards including NCQA, HEDIS, HHSC, and TDI requirements.
- Protect confidential and protected health information.
Skills
utilization, RN, Quality assurance, outpatient, case management, disease management, discharge planning, care coordination, HEDIS, NCQA, Regulatory compliance, health care, microsoft office, ehr, epic
Top Skills Details
utilization,RN,Quality assurance,outpatient,case management,disease management,discharge planning,care coordination,HEDIS,NCQA,Regulatory compliance
Additional Skills & Qualifications
Clinical knowledge in the treatment of injuries, diseases and deformities including symptoms, treatment alternatives, drug properties and interactions and preventive health guidelines.
- Working knowledge of Case Management principles and processes
- Experience in Medicaid Managed Care including STAR and CHIP.
- Experience with Commercial, Health Care Exchange Programs and other county programs...
- Knowledge of HHSC, TDI, NCQA and HEDIS regulations, standards, or measures to assure overall compliance with all standards.
- Working knowledge in the use of a personal computer and of Microsoft Office products including Word, Excel, Outlook, and Power Point.
Best candidates would have a managed care experience working with Medicaid OR marketplace.
NON-NEGOTIABLE: Active, unrestricted State Registered Nursing license in good standing. (We can look this up online prior to subbing over).
Always an A++ Nurse: Case Management Certification (CCM), Utilization Management Certification (CPHM) or other healthcare certification.
Experience Level
Intermediate Level
Job Type & Location
This is a Contract to Hire position based out of Austin, TX.
Pay and Benefits
The pay range for this position is $36.00 - $40.00/hr.
Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors.
Eligibility requirements apply to some benefits and may depend on your job
classification and length of employment. Benefits are subject to change and may be
subject to specific elections, plan, or program terms. If eligible, the benefits
available for this temporary role may include the following:
• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)
Workplace Type
This is a fully remote position.
Application Deadline
This position is anticipated to close on Aug 18, 2026.
We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
We’re a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We’re a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We’re strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We’re building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.
Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.
We’re TEKsystems and TEKsystems Global Services. We accelerate business transformation for our customers, so they can capitalize on change and master the momentum of technology. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We’re building tomorrow by delivering business outcomes and making positive impacts in our global communities.
TEKsystems and TEKsystems Global Services are Allegis Group companies.
