[Hiring] Managed Care Case Manager @Touch Support

Role Description

We are seeking a motivated, detail-oriented individual in the Philippines to join our team as a Managed Care Case Manager.

• 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.

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, 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.

Requirements

• Required work experience: 2-4 years
• Location: 100% Remote, open to all applicants in the Philippines.
• Full-time (US business hours align), including dedicated Weekend Coverage.

Benefits

• Starting salary: $665 – $800 USD Gross monthly.
• Comprehensive Training: Extensive initial training and ongoing mentorship.
• A Clear Career Ladder: Clear promotional path with competitive salary increases.
• A Supportive Global Team: Dedicated Team Lead and supervisor.
• A Dynamic Work Environment: Constant communication with native English speakers.