Remote Managed Care Manager - US Health Insurance Ops

Touch Support, Inc. & SNF Back Office; Región Centro; Presencial; MXN 126.000 - 151.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Comprehensive training

Clear career ladder

Global team support

Remote work environment

Descripción de la vacante

Touch Support, a multinational Business Process Optimization company, is seeking a Managed Care Case Manager for a 100% remote role in Mexico. Ideal candidates have 2–4 years in RN/LPN/USRN or Healthcare Virtual Assistant with nursing education and knowledge of US payer systems.

The role requires strong English, attention to detail, and the ability to handle high-volume authorizations. You will manage pre-admission and prior authorizations, conduct reviews, track authorizations, and coordinate

Formación

• 2–4 years of RN/LPN/USRN or Healthcare Virtual Assistant experience 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

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

Descripción del empleo

Touch Support, a multinational Business Process Optimization company, is seeking a Managed Care Case Manager for a 100% remote role in Mexico. Ideal candidates have 2–4 years in RN/LPN/USRN or Healthcare Virtual Assistant with nursing education and knowledge of US payer systems.

The role requires strong English, attention to detail, and the ability to handle high-volume authorizations. You will manage pre-admission and prior authorizations, conduct reviews, track authorizations, and coordinate