Managed Care Case Manager
需要工作经验：2-4 年 地点：100%远程 - 在菲律宾开放给所有申请人。我们是谁？多国企业流程优化公司 Touch Support 正在迅速扩大其财务和支持团队。我们在菲律宾寻找一个有动机，细节的个人加入我们的团队作为管理护理案例经理。美国和欧洲各地350多名员工以及成功远程登录的记录，我们很高兴为像你这样的才华横溢的专业人士提供长期机会。我们正在寻求24年的 RN,LPN,USRN 或医疗保健虚拟助手经验。· 美国医疗保险，医疗福利，医疗补助 MCOs,商业支付人和 InterQual/MCG 等标准的知识是个优势。· 与 PointClickCare,MatrixCare,Availity,NaviHealth 或类似系统的经验。·强大的英语沟通，组织，细节关注和时间管理技能。·能够独立管理大量授权工作流程。·转班和日程 - 全职 （美国营业时机一致）,包括周末覆盖。你要做什么？·与 MCOs 进行预入学和先前授权管理。·同时进行审查和临床审计以支持持续停留图表。· · 随时跟踪授权，停留时间和期限以防止覆盖缺口和收入损失。· 与保险案例经理，医疗总监和设施临床团队沟通。· 在被拒绝覆盖时支持同行评审和上诉。·与接入，护理，社会工作和收费团队协调。· 在 EHR 中保持准确的授权记录。·提供周末/高量覆盖并确保团队交付顺利。我们提供的：· 初步工资：$665 $800美元月均值 ·全面培训：我们为你提供广泛的初始培训和持续指导来建立成功角色。· 一个明确的职业阶梯：这只是开始。· 支持全球团队：尽管我们从家工作，但我们的团队紧密联系在一起。你将拥有专业的团队领导和监督员 · 动态的工作环境：你将与母语英语说者保持持续沟通，帮助你进一步提高你在职业语言技能
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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
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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 (US business hours align), including dedicated Weekend Coverage.
What You’ll Do
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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:
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Starting salary: $665 – $800 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.
Please submit your application and resume in English. Applications submitted in any other language will not be considered.Originally posted on Himalayas