Managed Care Case Manager

Touch Support, Inc. & SNF Back Office; Philippines; Remote; PHP 432,000 - 518,000; Full time

Job summary

Touch Support, Inc. & SNF Back Office in the Philippines is seeking a Managed Care Case Manager for a 100% remote role.

The position requires 2–4 years as an RN, LPN, USRN, or Healthcare Virtual Assistant with clinical nursing education and knowledge of US healthcare insurance, Medicare Advantage, Medicaid MCOs, and related systems. You will manage pre-authorizations, conduct concurrent reviews, track authorizations and lengths of stay, and communicate with case managers and facility teams.

Qualifications

• 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 like 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.

Responsibilities

• 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.

Skills

RN/LPN/USRN

Healthcare VA

Tools

PointClickCare

MatrixCare

Availity

NaviHealth

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