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Telephonic Nurse Case Manager Jobs in Spring, TX

PARADIGM HEALTHCARE

Nurse Case Manager

Houston, TX · On-site

$80 - $100/hr

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 ...

Altus ACE

RN Case Manager

Houston, TX

$80K/yr

Job Title: RN - Case Manager Status: Exempt Reports To: Nurse Manager Salary: Up to $80,000 DOE ... Assessments may be in person or telephonic. Assists with teaching and coordinating medical and ...

Altus ACE

RN Case Manager

Houston, TX · On-site

$80K/yr

Job Title: RN - Case Manager Status: Exempt Reports To: Nurse Manager Salary: Up to $80,000 DOE ... Assessments may be in person or telephonic. Assists with teaching and coordinating medical and ...

Nexus Health Systems

RN Case Manager

Conroe, TX · On-site

RN Case Manager Nexus Children's Hospital - Shenandoah Full-Time | Monday-Friday | Day Shift About Nexus Children's Hospital - Shenandoah Nexus Children's Hospital - Shenandoah specializes in ...

St. Michael's Hospice

RN Case Manager

Houston, TX · On-site

**Job Title: RN Case Manager** ** ** We are seeking a dedicated and compassionate RN Case Manager to join our dynamic healthcare team. The ideal candidate will excel in coordinating patient care ...

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Telephonic Nurse Case Manager information

See Spring, TX salary details

$14

$32

$53

How much do telephonic nurse case manager jobs pay per hour?

As of Sep 8, 2026, the average hourly pay for telephonic nurse case manager in Spring, TX is $32.47, according to ZipRecruiter salary data. Most workers in this role earn between $26.30 and $34.23 per hour, depending on experience, location, and employer.

What is a telephonic nurse case manager?

A Telephonic Nurse Case Manager is a registered nurse who coordinates and manages patient care over the phone. They assess patients’ needs, develop care plans, provide education, and serve as a liaison between patients, doctors, and insurance companies. Their main goal is to ensure patients receive effective and appropriate care while promoting recovery and cost-efficiency. This role is commonly found in insurance companies, hospitals, and managed care organizations, focusing on patients with chronic conditions, injury, or complex health needs.

How does a telephonic nurse case manager typically collaborate with physicians and other healthcare providers?

Telephonic Nurse Case Managers frequently coordinate care by acting as a liaison between patients, physicians, and other healthcare professionals. They relay important updates, clarify treatment plans, and ensure that all parties are aligned regarding the patient's care goals. This role often involves regular phone or electronic communication to discuss patient progress, address concerns, and advocate for necessary services. Strong collaborative and communication skills are essential, as case managers must foster trust and teamwork across interdisciplinary teams to achieve optimal patient outcomes.

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

To excel as a Telephonic Nurse Case Manager, you need a valid RN license, expertise in care coordination, and a thorough understanding of clinical protocols. Familiarity with case management software, telehealth platforms, and utilization review systems is often required. Outstanding communication, critical thinking, and organizational skills are essential for managing patient care remotely and collaborating with healthcare teams. These competencies ensure efficient, high-quality patient outcomes and seamless care coordination in a virtual environment.

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

AspectTelephonic Nurse Case ManagerUtilization Review Nurse
CredentialsRN license, case management certification often preferredRN license, certification in utilization review or related fields
Work EnvironmentRemote or telecommuting, healthcare organizations, insurance companiesRemote or hospital/clinic settings, insurance companies, healthcare facilities
Primary FocusCoordinate patient care, advocate for patients, manage casesAssess medical necessity, approve or deny services based on criteria

Both roles require RN licensure and involve remote work within healthcare or insurance settings. The Telephonic Nurse Case Manager focuses on patient advocacy and care coordination, while the Utilization Review Nurse primarily evaluates the necessity of services for approval or denial. Understanding these differences helps in choosing the right career path or job search focus.

What are popular job titles related to Telephonic Nurse Case Manager jobs in Spring, TX?

For Telephonic Nurse Case Manager jobs in Spring, TX, the most frequently searched job titles are:

What job categories do people searching Telephonic Nurse Case Manager jobs in Spring, TX look for?

The top searched job categories for Telephonic Nurse Case Manager jobs in Spring, TX are:

What cities near Spring, TX are hiring for Telephonic Nurse Case Manager jobs?

Cities near Spring, TX with the most Telephonic Nurse Case Manager job openings:

Telephonic Nurse Case Manager jobs near you
Infographic showing various Telephonic Nurse Case Manager job openings in Spring, TX as of August 2026, with employment types broken down into 87% Full Time, 12% Part Time, and 1% Contract. Highlights an 79% Physical, 3% Hybrid, and 18% Remote job distribution, with an average salary of $67,535 per year, or $32.5 per hour.

Nurse Case Manager

Paradigm Healthcare Services

Houston, TX • On-site

Other

Re-posted yesterday

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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