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 join our team 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 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 cases
Qualifications:
- 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 $30.00 per hour Benefits:
- 401(k)
- Dental insurance
- Flexible spending account
- Health insurance
- Health savings account
- Paid time off
- Referral program
- Vision insurance
Work Location: Remote