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Remote Nurse Case Manager - Utilization Review SNF

Work from home Full-time role Hiring

Remote Case Manager – Utilization Review (SNF) We are seeking a licensed nurse with strong Skilled Nursing Facility (SNF) experience to join reputed company as a Remote Case Manager in Utilization Review. This role involves evaluating medical necessity, coordinating care, and ensuring appropriate service utilization for managed care members. Key Responsibilities:

  • Conduct utilization reviews for medical necessity.
  • Complete insurance updates for managed care members.
  • Process pre-certifications and review reputed company authorizations.
  • Collaborate with providers and payers to resolve authorization issues.
  • Maintain accurate and compliant case documentation.
  • Complete reporting and coordinate with internal billing team on reputed company cases

Qualifications:

  • Licensed nurse (RN or LVN/LPN).
  • Skilled Nursing Facility (SNF) experience required.
  • Experience with managed care, pre-certification, or reputed company review processes.
  • Strong communication, critical thinking, and organizational skills

Job Type: Full-time Pay: From $30.00 per hour Benefits:

  • 401(k)
  • Dental insurance
  • Flexible spending account
  • Health insurance
  • Health savings account
  • Paid time off
  • Referral program
  • reputed company insurance

Work Location: Remote Apply tot his job Apply To this Job

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