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Virtual Case Manager Jobs in Puerto Rico (NOW HIRING)

OncoHealth

Case Review Representative

Guaynabo, PR · On-site +1

$13 - $15/hr

... treatment review and virtual care across all cancer types. About the Role The Case Review ... Triage and manage inbound calls, routing case specific calls to an appropriate team member, and ...

OncoHealth

Case Review Specialist - PR

Guaynabo, PR · On-site +1

... treatment review and virtual care across all cancer types. About the Role The Case Review ... Our Current Solutions Through the use of OncoHealth's utilization management system, OneUM , our ...

OncoHealth

Case Review Specialist - PR

Guaynabo, PR · On-site

... treatment review and virtual care across all cancer types. About the Role The Case Review ... Our Current Solutions Through the use of OncoHealth's utilization management system, OneUM , our ...

OncoHealth

Case Review Representative

Guaynabo, PR · On-site

... treatment review and virtual care across all cancer types. About the Role The Case Review ... Triage and manage inbound calls, routing case specific calls to an appropriate team member, and ...

Vivo HealthStaff

Psychologist - Telemedicine

San Juan, PR · On-site

$35 - $40/hr

... virtual therapy sessions. Key Responsibilities: - Provide individual, group, and family therapy ... case managers, and support staff to ensure comprehensive patient care. - Participate in regular ...

Vivo HealthStaff

$30 - $40/hr

... virtual therapy sessions. Key Responsibilities: - Provide individual, group, and family therapy ... case managers, and support staff to ensure comprehensive patient care. - Participate in regular ...

Elevance Health

Operations Expert (US)

San Juan, PR · On-site

... case research and resolution; reviews, interprets and maintains records of service level, quality ... Unless specified as primarily virtual by the hiring manager, associates are required to work at an ...

Elevance Health

Operations Expert (US)

San Juan, PR · On-site

... case research and resolution; reviews, interprets and maintains records of service level, quality ... Unless specified as primarily virtual by the hiring manager, associates are required to work at an ...

Nazareno Diabetes Care

PR · On-site

... virtual clinics. * Support clinic operations by: * Preparing patients for their session * Managing ... Escalates any complex clinical case to the Clinical Specialist. Qualifications: Education

Fora Pathways Inc

PR · On-site

$15/hr

Proficiency in using computer software for case management and reporting. * Bilingual abilities ... Familiarity with virtual job search tools and work platforms. Physical Requirements * Ability to ...

New

Elevance Health

PR · On-site

... case research and resolution; reviews, interprets and maintains records of service level, quality ... Unless specified as primarily virtual by the hiring manager, associates are required to work at an ...

Fora Pathways Inc

PR · On-site

$15/hr

Proficiency in using computer software for case management and reporting. * Bilingual abilities ... Familiarity with virtual job search tools and work platforms. Physical Requirements * Ability to ...

New

DaVita

Transplant Liaison - Anaheim, CA

Arecibo, PR · On-site

$80K/yr

Experience working with ESKD, and transplant patients in a clinical or case management setting ... offers on-demand virtual leadership and development courses through DaVita's online training ...

All JobsCase JobsVirtual Case Manager JobsVirtual Case Manager Jobs in Puerto Rico

Virtual Case Manager information

What does a typical day look like for a Virtual Case Manager?

A typical day for a Virtual Case Manager involves assessing new client cases, conducting regular check-ins via phone or video calls, updating case files in digital management systems, and coordinating resources or referrals. You’ll often collaborate with healthcare providers, insurance representatives, or social service agencies to ensure clients receive appropriate support. Additionally, you may spend time tracking progress, addressing urgent client needs, and participating in team meetings. While the position is largely remote, strong communication and time management skills are essential for balancing multiple cases and deadlines effectively.

What are the key skills and qualifications needed to thrive in the Virtual Case Manager position, and why are they important?

To thrive as a Virtual Case Manager, you need expertise in case management, client assessment, and care coordination, often supported by a relevant degree in social work, nursing, or a related field. Proficiency with case management software, secure communication platforms, and compliance tools such as HIPAA training is highly valuable. Strong interpersonal communication, problem-solving abilities, and organizational skills distinguish top performers in this remote role. These skills and qualifications are crucial for effectively supporting clients, managing complex cases, and ensuring seamless service delivery in a virtual environment.

What is a Virtual Case Manager job?

A Virtual Case Manager is a professional who provides remote case management services, typically in healthcare, social work, or insurance fields. They assess client needs, develop care plans, coordinate services, and monitor progress using digital tools and communication platforms. Their role ensures clients receive appropriate resources and support while working remotely. Effective virtual case managers must have strong organizational, communication, and problem-solving skills.

What job categories do people searching Virtual Case Manager jobs in Puerto Rico look for? The top searched job categories for Virtual Case Manager jobs in Puerto Rico are:
What cities in Puerto Rico are hiring for Virtual Case Manager jobs? Cities in Puerto Rico with the most Virtual Case Manager job openings:
Virtual Case Manager jobs near you
Infographic showing various Virtual Case Manager job openings in Puerto Rico as of July 2026, with employment types broken down into 1% As Needed, 80% Full Time, 17% Part Time, and 2% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution.
Case Review Representative

Case Review Representative

OncoHealth

Guaynabo, PR • On-site, Remote

$13 - $15/hr

Full-time

Posted 17 days ago

Job description

About OncoHealth
OncoHealth is a leading digital health company dedicated to helping health plans, employers, providers, and patients navigate the physical, mental, and financial complexities of cancer through technology enabled services. Supporting more than 14 million people in the US and Puerto Rico, OncoHealth offers digital solutions for treatment review and virtual care across all cancer types.
About the Role
The Case Review Representative serves as a one-stop shop and intake of all calls (members and providers). Resolves tier one issues (user resets, provider data management, fax and letter receipt, general questions).
Primary Responsibilities
  • Flexible to work rotational shifts inside our office hours from 8:00 a.m. – 8:00 p.m. EST to cover the operational needs of the company. Shifts can range anywhere between Monday – Friday 8:00 am to 8:00 pm EST and Saturdays 8:30 am - 5:00 pm EST (Office hours may change/extend upon operational needs)
  • Fax intake and labeling
  • Prior authorization creation
  • Quality Performance Program Outreach when assigned
  • Triage and manage inbound calls, routing case specific calls to an appropriate team member, and resolving tier 1 level issues
  • Triage and manage inbound emails from health plan clients, routing case specific emails to an appropriate team member, and resolving tier 1 level issues
  • Triage request/claims processing issues to health plans as needed Prior authorization creation
  • Quality Performance Program Outreach when assigned
About You
  • College degree or relevant experience preferred
  • Fully Bilingual (English and Spanish)
  • Remote/hybrid work experience preferred
  • A minimum of 2 years of healthcare related administrative experience and/or customer service or relevant educational attainment required
  • Skills for implementation of systems for program effectiveness and productivity required
  • Systems/Tools: MS Office Suite proficient
About the Location
OncoHealth is committed to remote, hybrid or in office work options. Our Team in Puerto Rico reports to the office at least 2 times per month (advance notice provided/mandatory requirement) and can work remotely from home the rest of the days. Employees are welcome to work from the office every day if wanted.

Our Culture

Taking ownership of quick action, critically thinking through the needs, and working well with others are key competencies of team member success. Our leadership is dedicated to building a culture based on respect, clinical excellence, innovation – all with a focused mission of putting patients first!

We offer a full benefit package on your first day, along with a company bonus. You may visit or work from our very modern and engaging offices, and experience a fun, collaborative environment where social activities and community events matter. We enjoy being together!
OncoHealth is committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and team members without regard to race, color, religion, marital status, age, national origin, ancestry, physical or mental disability, medical condition, pregnancy, genetic information, gender, sexual orientation, gender identity or expression, veteran status, or any other status protected under federal, state, or local law. All employment decisions are based on qualifications, merit, and business need.

The Opportunity

The cost of cancer related medical services and prescription drugs in the United States is expected to reach $246 billion by 2030. OncoHealth has enjoyed rapid growth over the past 3 years and seeks smart, collaborative people to join its team. We have just under 250 team members, so we can move swiftly but precisely to the market needs of our customers. Strongly backed financially by Arsenal Capital Partners amp; McKesson Corporation, we remain in an investment and growth mode. This means we are open-minded to how we get the work done – now is the perfect time to talk to us!

Our Current Solutions

Through the use of OncoHealth's utilization management system, OneUM, our customers can use a single e-Prior Authorization portal for all oncology drug request and treatments. Our system improves quality of care, reduces provider abrasion and gives health plans visibility into the total cost of oncology treatment.

OncoHealth offers Oncology Insights Pro, an analytic software solution that enables health plans to use data and analytics to improve oncology programs. Using real world data, our engineers normalize data to create analytic dashboards with drill down compatibilities. The data is the paired with expert guidance providing the strategies an insight needed to keep up with the continuing evolving cancer treatment landscape.

OncoHealth offers Pharmacy Consulting services to health plans and pharmaceutical companies. New cancer treatments are entering the market at an unrelenting pace. Since 2018, the FDA approved 121 new cancer applications including 49 novel cancer drug entities. Our Board-Certified Oncology Pharmacologists can help health plans update drug policies, offer utilization management and formulary advice, and development training for staff.

OncoHealth's latest offering is Iris, a digital telehealth platform that delivers personalized, oncology-specific support to navigate the physical symptoms and emotional challenges caused by cancer and cancer treatment. Powered by technology, staffed 24X7, and delivered with empathy, Iris allows patients to connect with trained oncology experts and receive personalized, oncology-specific telehealth support.

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