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Value Based Case Management Senior Analyst - RN - Houston, TX

Health Care Service Corporation
life insurance, parental leave, paid time off, paid holidays, tuition reimbursement, 401(k)
United States, Texas, Houston
Jul 25, 2025

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Join HCSC and be part of a purpose-driven company that will invest in your professional development.

Job Summary This position is responsible for coordinating and manage relationships with participating provider practices. Maintain detailed understanding of HEDIS / STAR performance measures. Develop and maintain a process to ensure all customers participating in provider practices meet all quality metrics. Responsible for coordinating the delivery of cost-effective, quality -based health care services for health plan customers by development and implementation of alternative treatment plans that address individual needs of the customer, their benefit plan, and community resources. Plans, implements, and evaluates appropriate health care services in conjunction with the physician treatment plan. Utilizes clinical skills to assess, plan, implement, implement, coordinates, monitor and evaluates options and services to facilitate appropriate healthcare outcomes for customers.

Required Job Qualifications:

  • Current Licensure as a registered nurse, in the state of residence in good standing.
  • Associates degree, diploma, or B.S. in Nursing
  • Three to Five (3-5) years recent experience in an acute-care environment, case-management, or utilization management position (experience can be a combination of LVN/RN licensure)
  • Previous HEDIS and/or CMS STARs experience a plus.

Preferred Job Qualifications:

  • Bilingual (English/Spanish)
  • Previous HEDIS and/or CMS STARs experience
  • Strong proficiency level using Microsoft Excel
  • FACETs experience is preferred
  • Client-site Location: This is a field based position in the Central and South Houston, TX market. The individual will be onsite at provider offices daily.
  • Schedule: Monday - Friday, typical business hours
  • Sponsorship: Sponsorship is not available.

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Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

Pay Transparency Statement:

At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards.

The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plansubject to the terms and the conditions of the plan.

HCSC Employment Statement:

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

Base Pay Range$54,800.00 - $121,100.00
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