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