Managed Care Case Manager

Touch Support, Inc. & SNF Back Office; Medellín; Presencial; COP 20.836.000 - 24.958.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Comprehensive Training

Career Ladder

Global Team

Remote Work Environment

Descripción de la vacante

Touch Support, Inc. & SNF Back Office in Colombia is seeking a Managed Care Case Manager to join our remote finance and support teams. You will handle pre-admission authorizations, concurrent reviews, and track expirations while coordinating with insurers and clinical teams.

We require 2–4 years of RN/LPN/USRN or Healthcare Virtual Assistant experience with clinical nursing education, strong English, and the ability to manage high-volume workflows on US business hours.

Formación

• 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, and criteria such as InterQual/MCG is a plus.
• Experience with the listed systems (PointClickCare, MatrixCare, Availity, NaviHealth) is beneficial.
• Strong English communication, organization, attention to detail, and time-management skills.
• Ability to manage high-volume authorization workflows independently.
• Shift & Schedule: full-time, 5 days per week (US business hours align - 7 AM - 3 PM CDT), including dedicated Weekend Coverage.

Responsabilidades

• 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.
• 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.

Conocimientos

English communication

Organization

Time management

Attention to detail

Workflow management

Educación

Nursing degree

Herramientas

PointClickCare

MatrixCare

Availity

NaviHealth

Descripción del empleo

Required work experience: 2-4 years

Required work experience: 2-4 years

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

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 Colombia 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, 5 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