Managed Care Case Manager
Straight from touchsupport’s careers page. Apply on the company site — no recruiter, no middleman.
Managed Care Case Manager
Location: Remote
Required work experience: 2-4 yearsLocation: 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 Assistant with 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 (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 – $800 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.
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