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Telephonic Case Management Jobs in Texas (NOW HIRING)

CVS Health

Case Manager Registered Nurse

Mountain Home, TX · On-site

$60K - $129K/yr

... provide telephonic case management support for members with complex healthcare needs. In this role, you will assess, plan, coordinate, and manage care while helping members navigate resources ...

FCCI Insurance Group

Medical Case Manager

Richardson, TX · On-site +1

$62K - $96K/yr

We are seeking a licensed Registered Nurse to provide telephonic case management on assigned workers' compensation claims. The selected new hire will provide coordination and evaluation of medical ...

CVS Health

Case Manager, Registered Nurse

Mountain Home, TX · On-site

$54K - $155K/yr

AHH delivers flexible medical management services that support cost-effective quality care for members. Key Responsibilities * This position consists of working intensely as a telephonic case manager ...

Oscar Health

CCM Case Management RN

Dallas, TX

$32.60 - $42.79/hr

Telephonic case management role in which you will educate members on improving health outcomes, assist with transitions from care settings, participate in process improvement and other pilot programs ...

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Telephonic Case Management information

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How much do telephonic case management jobs pay per hour?

As of Aug 24, 2026, the average hourly pay for telephonic case management in Texas is $22.75, according to ZipRecruiter salary data. Most workers in this role earn between $14.33 and $31.01 per hour, depending on experience, location, and employer.

What is telephonic case management?

Telephonic case management is a process where healthcare professionals, often nurses or social workers, manage and coordinate patient care over the phone. This service involves assessing patient needs, developing care plans, monitoring patient progress, and providing education and support—all remotely. Telephonic case management is commonly used to help patients with chronic illnesses, those transitioning from hospital to home, or individuals who require ongoing support but may have difficulty attending in-person appointments. It helps improve access to care, enhance patient outcomes, and reduce healthcare costs by preventing unnecessary hospitalizations.

What are the key skills and qualifications needed to thrive as a telephonic case manager, and why are they important?

To thrive as a Telephonic Case Manager, you need a background in nursing or social work, strong clinical assessment abilities, and relevant licensure such as RN or LCSW. Familiarity with case management software, electronic health records, and telehealth platforms is typically required. Excellent communication, problem-solving, and empathy are essential soft skills for effectively supporting patients remotely. These skills ensure coordinated, patient-centered care and positive health outcomes in a virtual environment.

What are some common challenges faced in a telephonic case management role, and how can they be overcome?

One common challenge in Telephonic Case Management is building rapport and trust with clients without face-to-face interaction. Case managers also navigate managing high caseloads and coordinating care among various providers remotely. Effective communication, strong organizational skills, and the ability to use technology efficiently are key to overcoming these challenges. Regular training on call management and active listening techniques can also help case managers deliver high-quality, patient-centered care and maintain strong professional relationships.

What is the difference between Telephonic Case Management vs Utilization Review Nurse?

AspectTelephonic Case ManagementUtilization Review Nurse
CredentialsRN, CCM or similar certificationsRN, often with certifications like URAC or CUC
Work EnvironmentRemote, phone-based case managementRemote or hospital-based review settings
Employer & IndustryInsurance companies, healthcare providersInsurance companies, healthcare organizations
Primary FocusCoordinating patient care and servicesAssessing medical necessity for services

While both roles involve remote work and require nursing credentials, Telephonic Case Management focuses on coordinating ongoing patient care, whereas Utilization Review Nurses primarily evaluate the necessity of medical services for insurance approval.

How to become a telephonic case management?

To become a telephonic case manager, typically one needs a bachelor's degree in healthcare, social work, or a related field, along with relevant experience in case management or healthcare settings. Certification such as the Certified Case Manager (CCM) or Certified Managed Care Professional (CMCP) can enhance job prospects. Strong communication skills, knowledge of healthcare systems, and proficiency with electronic health records are also important.

Is telephonic case management a stressful job?

Telephonic case management can be stressful due to the need to handle complex cases, communicate effectively with clients and healthcare providers, and meet productivity targets. The role often requires strong organizational skills, emotional resilience, and the ability to manage high call volumes within set schedules.

What are popular job titles related to Telephonic Case Management jobs in Texas?

For Telephonic Case Management jobs in Texas, the most frequently searched job titles are:

What job categories do people searching Telephonic Case Management jobs in Texas look for?

The top searched job categories for Telephonic Case Management jobs in Texas are:

Telephonic Case Management jobs near you
Infographic showing various Telephonic Case Management job openings in Texas as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 13% Part Time, 3% Contract, and 1% Nights. Highlights an 82% Physical, 3% Hybrid, and 15% Remote job distribution, with an average salary of $47,316 per year, or $22.7 per hour.

Nurse Case Manager

Paradigm Healthcare Services

Houston, TX • On-site

Other

Re-posted 16 days ago

Job description

Paradigm Healthcare LLC is Hiring a Licensed Nurse Case Manager
In keeping with the organization's goals, the Case Manager/ Prior Authorization Liaison- Managed Care Department, is responsible for providing comprehensive telephonic case management, insurance verification, and authorization services for our skilled nursing facilities (SNFs). This role supports the managed care continuum from referral and admission through ongoing utilization review, discharge planning, and continuation of care.
The position partners closely with Managed Care Organizations (MCOs), referral sources, and facility leadership to promote managed care census growth, ensure appropriate levels of care, maximize contractual and reimbursement opportunities, and maintain compliance with payer and regulatory requirements. Acting as a primary liaison between facilities and payers, the Case Manager/ Prior Authorization Liason ensures effective communication, continuity of care, and optimal clinical and financial outcomes for SNF patients.
Essential Duties and Responsibilities
Case Management & Utilization Review
  • Provide telephonic case management support to assigned skilled nursing facilities.
  • Maintain active and accurate case files for SNF patients in PointClickCare (PCC), including Admin Notes, A/R insurance tabs, and shared Case Management logs.
  • Review benefits verification and authorization data to ensure patients are placed at the appropriate level of care for contractual optimization; renegotiate rates when applicable.
  • Notify MCOs of clinical admissions and initiate required clinical assessments.
  • Review admission clinical documentation to determine appropriate target discharge plans.
  • Conduct timely initial reviews, concurrent reviews, and continued stay reviews with MCOs to ensure covered days and reimbursement.
  • Chair and facilitate weekly case conference calls with supported facilities.
  • Assist facility interdisciplinary teams in developing appropriate goals of care and treatment plans for SNF patients.
  • Coordinate all Notice of Medicare Non-Coverage (NOMNC) processes and track appeals in collaboration with facility teams.
  • Obtain accurate payer information to support continuation of care and discharge planning.
Authorization & Referral Management
  • Represent the organization professionally to referral sources, managed care representatives, and external partners; maintain positive, collaborative relationships.
  • Enter and manage referral leads, including Return to Acute (RTA) leads, in the PointClickCare CRM module.
  • Verify insurance benefits and facility network participation through PCC, MCO portals, and direct payer communication.
  • Submit, track, and follow up on all insurance authorization requests electronically or manually, as required.
  • Update referral and authorization status throughout the PDG authorization and approval stages of the referral process.
  • Coordinate physician assignment upon referral and authorization approval.
  • Collaborate with Referral Management and Placement Specialists to ensure all coverage and documentation requirements are met.
  • Communicate referral source or payer issues promptly to appropriate internal stakeholders.
  • Negotiate appropriate levels of care and contracted rates with MCOs as necessary.
Care Coordination & Support Functions
  • Serve as the primary liaison between the MCO and facility for all case-related communication.
  • Assist facilities in identifying in-network home health and durable medical equipment (DME) providers.
  • Support billing and revenue cycle teams with authorization clarification, reimbursement issues, and census updates as needed.
  • Participate in daily or routine pipeline and case review meetings as required.
  • Perform additional duties within the Case Management Department as assigned to support organizational objectives.
Supervisory Responsibility
This position has no direct supervisory responsibilities.
Required Education, Experience, and Skills
  • Active Nurse License
  • Minimum of two (2) years of experience in:
    • Skilled nursing facility case management, including initial reviews, concurrent reviews, and NOMNC processes, and/or
    • Managed care verification of benefits and insurance authorization processes.
  • Strong and demonstrated experience using PointClickCare software in a skilled nursing facility environment.
  • Proficient computer skills, including Microsoft Outlook, Microsoft Office Suite, Microsoft Teams, and payer portals.
  • Recent skilled long-term care experience required.
  • Ability to make independent decisions using sound judgment and critical thinking.
  • Self-motivated, self-directed, and able to work independently in a fast-paced environment.
  • Excellent written and verbal communication skills.
  • Strong organizational, negotiation, and relationship-management skills.
  • Ability to establish and maintain effective working relationships with internal teams, facilities, and external organizations.

Position Type and Expected Hours of Work
This position supports healthcare facilities that operate 24 hours per day, 7 days per week. While the role is primarily Monday through Friday, scheduled weekend and holiday coverage may be required based on business needs.
Work Environment and Physical Demands
This position routinely uses standard office equipment, including computers, phones, and photocopiers. The work environment is primarily office-based with physical demands consistent with a professional healthcare management role.
Other Duties
This job description is not intended to be a comprehensive list of all duties, responsibilities, or activities. Duties may change at any time with or without notice.
Reasonable Accommodation
Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions of this position.

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