Remote Nurse Case Manager: Care Coordination & Education

TEKsystems; Austin (TX); On-site; USD 50,000 - 55,000; Full time

Benefits offered by this job

Medical Benefits

401(k) Plan

Life Insurance

Paid Time Off

Job summary

TEKsystems seeks a Nurse Case Manager to manage a caseload of high-risk, high-cost members from Austin, TX, with a fully remote work arrangement. The role focuses on disease management, member advocacy, and education to improve health outcomes.

You will conduct telephonic assessments, develop individualized care plans, coordinate services, and ensure accurate documentation in compliance with NCQA, HEDIS, HHSC, and TDI requirements. A State RN license and Medicaid experience are preferred.

Qualifications

• Active, unrestricted State RN license in good standing.
• Experience with Medicaid Managed Care including STAR and CHIP.
• Managed care experience with Medicaid or marketplace.

Responsibilities

• Conduct telephonic assessments of high-risk, high-cost members.
• Identify medical, behavioral health, and social determinants affecting outcomes.
• Develop individualized care plans and measurable goals.
• Coordinate services among providers and community resources.
• Educate members on chronic conditions and self-management.
• Maintain accurate documentation and comply with NCQA/HEDIS requirements.

Skills

RN

Case management

Discharge planning

Care coordination

HEDIS

NCQA

Tools

EPIC

EHR

Microsoft Office

Job description

TEKsystems seeks a Nurse Case Manager to manage a caseload of high-risk, high-cost members from Austin, TX, with a fully remote work arrangement. The role focuses on disease management, member advocacy, and education to improve health outcomes.

You will conduct telephonic assessments, develop individualized care plans, coordinate services, and ensure accurate documentation in compliance with NCQA, HEDIS, HHSC, and TDI requirements. A State RN license and Medicaid experience are preferred.