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Managed Care Case Manager

Managed Care Case Manager

touch support, inc. & snf back office
2-4 Years
Not Disclosed
  • Posted 11 hours ago
  • Be among the first 10 applicants

Job Description

Required work experience: 2-4 years

Location: 100% Remote - Open to All Applicants in the Philippines.

Who Are We


Touch Support, a multinational Business Process Optimization company, is rapidly expanding its finance and support teams. We are seeking a motivated, detail-oriented individual in the Philippines to join our team as a Managed Care Case Manager. With over 350 employees across the US and Europe and a proven track record of successful remote onboarding, we are excited to offer this long-term opportunity to talented professionals like you.

What We're Looking For
  • 2–4 years of experience as an RN, LPN, USRN, or Healthcare Virtual Assistantwith clinical nursing education
  • Knowledge of US healthcare insurance, Medicare Advantage, Medicaid MCOs, commercial payors, and criteria such as InterQual/MCG is a plus
  • Experience with PointClickCare, MatrixCare, Availity, NaviHealth, or similar systems
  • Strong English communication, organization, attention to detail, and time-management skills
  • Ability to manage high-volume authorization workflows independently
  • Shift & Schedule - full-time, five days per week (US business hours align - 7 AM - 3 PM CDT), including dedicated Weekend Coverage
What You'll Do
  • Manage pre-admission and prior authorizations with MCOs, Medicare Advantage, and commercial insurers
  • Conduct concurrent reviews and clinical chart audits to support continued stays
  • Track authorizations, length of stay, and expiration dates to prevent coverage gaps and lost revenue
  • Communicate with insurance case managers, medical directors, and facility clinical teams
  • Support Peer-to-Peer reviews and appeals when coverage is denied
  • Coordinate with intake, nursing, social work, and billing teams
  • Maintain accurate authorization records in the EHR
  • Provide weekend/high-volume coverage and ensure smooth team handoffs
What We Offer:
  • Starting salary: 665 USD gross monthly
  • Comprehensive Training: We provide extensive initial training and ongoing mentorship to set you up for success
  • A Clear Career Ladder: This role is just the beginning. We offer a clear promotional path with competitive salary increases as you grow with us
  • A Supportive Global Team: Even though we work from home, our team is tightly connected. You will have a dedicated Team Lead and supervisor
  • A Dynamic Work Environment: You will be in constant communication with native English speakers, helping you to further enhance your language skills in a professional setting

Please submit your application and resume in English. Applications submitted in any other language will not be considered.

More Info

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Key Skills

NaviHealth

clinical nursing education

MatrixCare

LPN

Availity

InterQual

MCG

commercial payors

US healthcare insurance

Healthcare Virtual Assistant

PointClickCare

USRN

RN

MCOs