Remote Nurse Case Manager - Utilization Review SNF
Remote Case Manager – Utilization Review (SNF) We are seeking a licensed nurse with strong Skilled Nursing Facility (SNF) experience to as aRemote 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 concurrent 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 all casesQualifications: • Licensed nurse (RN or LVN/LPN). • Skilled Nursing Facility (SNF) experience required. • Experience with managed care, pre-certification, or concurrent review processes. • Strong communication, critical thinking, and organizational skills Job Type: Full-time Pay: From $28.00 per hour Expected hours: 36.5 – 40 per weekBenefits: • 401(k) • Dental insurance • Flexible spending account • Health insurance • Health savings account • Paid time off • Referral program • Vision insurance Work Location:Remote Apply tot his job