Managed Care Case Manager (Guadalajara)

Managed Care Case Manager (Guadalajara)

25 ago
|
Touch Support
|
Guadalajara

25 ago

Touch Support

Guadalajara

Required work experience: 2-4 years

Location: 100% Remote - Open to All Applicants in Mexico.

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 Mexico 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 - 7 AM - 3 PM CDT), 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 General 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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📌 Managed Care Case Manager (Guadalajara)
🏢 Touch Support
📍 Guadalajara

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