This paper outlines the origins of case management and the diverse meanings of the term. Through illustrations from two Australian policy examples of long-term unemployment and homelessness, it is argued that case management is now often a black box approach to service delivery, underpinned by an economic reform agenda. Analysis of the discourse associated with contemporary policy developments allows insight into the ways in which case management redefines descriptions of service delivery in the human services. It is argued that the rhetoric of case management may not have changed much over time but the motivation behind it may have, and its conceptualisation and theoretical development have not kept pace with practice. The paper concludes with adoption and implementation guidelines for case management.