Remote Telephonic RN – Clinical Case Manager

United-Biosource-Corporation; United States; Remote; USD 70,000 - 100,000; Full time

Benefits offered by this job

Remote opportunities

Competitive salaries

401K with company match

Tuition reimbursement

20 days PTO

Paid Holidays

Employee assistance programs

Medical, Dental, and vision coverage

Job summary

UBC in the United States is seeking a Clinical Case Manager to provide telephonic support for client funded contracts, reviewing payor criteria and performing clinical reviews for prior authorizations and appeals.

The role builds relationships with healthcare providers, supports patient access, and may require travel for training, meetings, and conferences. Licensing requirements include RN in state and Compact licenses; remote home-office work is supported.

Qualifications

• RN licensure in good standing in your state.
• Compact State License eligibility where applicable.
• Willing to obtain California licensure by endorsement.
• 2+ years’ experience in the PBM/healthcare industry.
• Strong ability to research, analyze, and document clearly.
• Excellent written and verbal communication; detail oriented.

Responsibilities

• Provide telephonic clinical support to providers and patients.
• Review payer coverage criteria and prior authorizations.
• Prepare clinical documentation for submissions and notes.
• Address escalated reimbursement issues with internal and external stakeholders.
• Participate in quarterly business reviews and client meetings.
• Travel for training, meetings, and conferences as required.

Skills

Communication skills

Problem solving

Multitasking

Written communication

Verbal communication

Attention to detail

Training teammates

Customer service

Education

Associate degree

RN license

Tools

Microsoft Excel

MS Office

Job description

UBC in the United States is seeking a Clinical Case Manager to provide telephonic support for client funded contracts, reviewing payor criteria and performing clinical reviews for prior authorizations and appeals.

The role builds relationships with healthcare providers, supports patient access, and may require travel for training, meetings, and conferences. Licensing requirements include RN in state and Compact licenses; remote home-office work is supported.