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Managed Care Case Manager

Touch Support

Role overview

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
  • Experience with PointClickCare, MatrixCare, Availity, NaviHealth, or similar systems
  • Strong English communication, organization, attention to detail, and time-management skills

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

Key facts

Hard skills

Intelligent Virtual Assistant Managed Care Medicare Advantage InterQual Criteria Pointclickcare Matrix Management Organizational Structure

Other skills

  • Communication
  • Detail Oriented
  • Time Management

About the company

Touch Support logo

Touch Support

Outsourcing & Offshoring

Touch Support has spent almost 20 years removing and preventing headaches for our clients and giving them peace of mind. As an IT as a Service (ITaaS) provider, we help organizations improve the management and performance of both their critical IT infrastructure and people resources. Touch Support’s personalized, customer-centric support and service offerings result in a pleasant user experience, time after time. Services offered range from colocation and data center services to complex, mission critical infrastructure deployments. We also provide organizations with reliable and expert IT outsourced helpdesk support solutions. Our outsourced customer support is provided 24/7 and is fully branded under your company’s name. We specialize in providing superior outsourced customer support in the following areas: Outsourced Web Hosting Support Outsourced SaaS Support Outsourced eCommerce Support Most recently, Touch Support created SNF Back Office, found at SNFBackOffice.com, which is a platform for healthcare companies, with a specific focus on Skilled Nursing Facilities, to get help with back office services and expenses. From Finance, Recruiting and IT, to our unique value focused 365 Savings Program and Cost Saving Assessments, we understand the needs of SNFs and healthcare companies today. Go to SNFBackOffice.com to learn more about our services.

Company details

Company typeSME
IndustryOutsourcing & Offshoring
Company size201 - 500

Links

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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 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.
  • Shift & Schedule - full-time (US business hours align), 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 – $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.

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MR

Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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