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 $28.00 per hour Expected hours: 36.5 – 40 per week Benefits: • 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