WFH Case Manager

TEKsystems; United States; Remote; USD 26,000 - 37,000; Part time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

401(k)

Life Insurance

Disability Insurance

HSA

PTO

Job summary

TEKsystems is seeking an Executive Case Manager to provide expertise on insurance coverage and reimbursement challenges facing patients, healthcare providers and clients. You will educate on access tools, advise on program eligibility, and educate HCP offices on payor processes.

The role involves building trusted relationships, managing inquiries, and delivering personalized case management while ensuring compliance with HIPAA and program procedures.

Qualifications

• Bachelor's degree (or higher) required.
• Healthcare administration or related field preferred.
• 2+ years in healthcare access delivery or management preferred.
• 5–10 years in insurance reimbursement or patient access will be considered in lieu of degree.
• Certification examples include PACS, CHES or CCM.
• Strong understanding of medical terminology and insurance processes.

Responsibilities

• Build trusted relationships with patients, prescribers and client stakeholders regarding reimbursement inquiries.
• Educate HCP offices on Payor processes and eligibility for programs.
• Manage inbound/outbound calls from patients, caregivers, and healthcare professionals.
• Explain coverage options and next steps in the access journey after Benefits Investigation.
• Handle client inquiries and HCP inquiries per business rules.
• Triage patients to internal or external resources.
• Provide personalized case management and outbound communication to HCPs and patients.

Skills

Medical terminology

ICD-10

CPT

HCPCS

Education

Bachelor's degree

Healthcare administration degree preferred

Certifications: PACS, CHES, CCM

Job description

Description

The Executive Case Manager provides expertise on insurance coverage and common access and reimbursement challenges affecting patients, healthcare providers and clients. The Executive Case Manager responsibilities include education on the access and reimbursement support tools available from Valeris and participating program, advising HCPs and/or patients and caregivers on the benefits and program eligibility for a specific patient, and educating HCP offices on Payor processes and procedures.

Key Responsibilities:

• Builds trusted relationships with patients, prescribers, and appropriate client stakeholders regarding reimbursement inquiries and challenges through proactive communication, timely and accurate execution of deliverables and demonstrated relentless passion for helping patients.
• Manages all relationships in a manner that adheres to all relevant laws, regulations, program-specific operating procedures and industry standards related to access and affordability, including HIPAA and insurance guidelines.
• Managed through call/contact center structure, this role supports inbound and outbound calls to patients, caregivers, specialty pharmacies and healthcare professionals.
• Performs post Benefits Investigation calls to patients and/or physicians explaining coverage options and next steps in the access journey.
• Manages all client inquiries as appropriate, such as case specific statuses.
• Manages HCP inquiries, as applicable, pursuant to business rules.
• All communications with the clients field teams will remain compliant and adhere to ways of working protocols outlined between Valeris and the client teams. Inbound Call Management
• Manages inbound calls as directed by the program-approved FAQs
• Triage patients to internal or external resources as appropriate.
• Personalized Case Management
• Provides personalized case management to patients and HCPs including outbound communication to HCPs, specialty pharmacies and patients to communicate

Additional Skills & Qualifications

• Completion of Bachelor's degree (or higher) required
• A degree in healthcare administration, social science or similar related fields is strongly preferred.
• Minimum two years of experience in healthcare access delivery or management is strongly preferred.
• 5-10 years of experience in insurance reimbursement, patient access, direct patient care, and/or patient education experience will be considered in lieu of degree.
• Will consider other certifications and five or more consecutive years of experience in relevant field. Certification examples include PACS (Prior Authorization Certified Specialist), CHES (Certified Health Education Specialist) or CCM in healthcare or social science (Certified Case Manager).
• Strong understanding of medical terminology, coding systems (ICD-10, CPT, HCPCS), and insurance processes.

Job Type & Location

This is a Contract position based out of Morrisville, NC.

Pay and Benefits

The pay range for this position is $23.00 - $23.00/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 jobclassification and length of employment. Benefits are subject to change and may besubject to specific elections, plan, or program terms. If eligible, the benefitsavailable for this temporary role may include the following:Medical, dental & visionCritical Illness, Accident, and Hospital401(k) Retirement Plan Pre-tax and Roth post-tax contributions availableLife Insurance (Voluntary Life & AD&D for the employee and dependents)Short and long-term disabilityHealth Spending Account (HSA)Transportation benefitsEmployee Assistance ProgramTime Off/Leave (PTO, Vacation or Sick Leave)

Job Type & Location

This is a Contract position based out of Morrisville, NC.

Application Deadline

This position is anticipated to close on Nov 13, 2026.

Workplace Type

This is a fully remote position.

About TEKsystems

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.

About TEKsystems and TEKsystems Global Services

Were 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. Were 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. Were strategic thinkers, hands‑on collaborators, helping customers capitalize on change and master the momentum of technology. Were 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.