Managed Care Case Manager
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 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.
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Strong English communication , organization, attention to detail, and time-management skills.
- Ability to manage high-volume authorization workflows independently.
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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.
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Conduct concurrent reviews and clinical chart audits to support continued stays.
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Track authorizations, length of stay, and expiration dates to prevent coverage gaps and lost revenue.
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Communicate with insurance case managers, medical directors, and facility clinical teams.
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Support Peer-to-Peer reviews and appeals when coverage is denied.
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Coordinate with intake, nursing, social work, and billing teams.
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Maintain accurate authorization records in the EHR.
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Provide weekend/high-volume coverage and ensure smooth team handoffs.
What We Offer:
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Starting salary: $665 – $800 USD Gross monthly
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Comprehensive Training: We provide extensive initial training and ongoing mentorship to set you up for success.
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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.
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A Supportive Global Team: Even though we work from home, our team is tightly connected. You will have a dedicated Team Lead and supervisor
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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