Remote Managed Care Case Manager (RN/LPN) – US Insurance

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

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.