Remote Managed Care Case Manager – RN/Healthcare Pro

Touch Support

Philippines

Remote

PHP 395,000 - 535,000

Full time

14 days+

Application generator

Stand out for this role — generate a tailored resume and cover letter in about a minute.

Get past ATS filters

Benefits offered by this job

Starting salary: 665 USD gross monthly

Comprehensive Training

Clear Career Ladder

Supportive Global Team

Dynamic English-speaking work env

Job summary

Touch Support is hiring a Managed Care Case Manager in the Philippines for a 100% remote position. The role requires 2–4 years of RN/LPN/USRN or Healthcare VA experience with nursing education and knowledge of US health insurance and payer criteria.

You will work US business hours with weekend coverage, handling authorizations and chart audits from home. The ideal candidate communicates effectively in English, manages high-volume tasks, and collaborates with insurers and clinical teams to

Qualifications

2–4 years of RN/LPN/USRN or Healthcare VA experience with nursing education.
Knowledge of US health insurance: Medicare Advantage, Medicaid MCOs, commercial payors.
Experience with PointClickCare, MatrixCare, Availity, NaviHealth, or similar systems.
Strong English communication and time-management skills.
Ability to manage high-volume authorization workflows independently.

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.