Call Center RN (Remote 11AM-8PM or 12PM-9PM ET)

United Biosource Corporation•All Virtual Locations, Home Based Position, USA, Remote, US,

6h•Remote

About The Position

UBC is hiring a Registered Nurse to perform as a Clinical Case Manager supporting healthcare providers and patients through telephonic support for client-funded contracts. The work includes provider support, reviewing payer-specific coverage criteria, completing clinical reviews of prior authorization and appeal submissions, and providing written communication using client-approved program resources. The role builds customer relationships and supports activities that facilitate patient access. This is a highly telephonic, desk-based position requiring continuous work in inbound and outbound call queues and virtual calls. Most of the workday is spent on the phone, with calls routed through a computer-based phone system and answered directly from the queue. The role is designed for a dedicated home office or HIPAA-compliant workspace, and UBC provides a desktop computer system rather than a laptop. The anticipated schedule is 11:00 AM–8:00 PM ET or 12:00 PM–9:00 PM ET, with the assigned shift based on business needs. A rotating Saturday shift from 9:00 AM–2:00 PM ET occurs approximately every five weeks and is paid as overtime; select rotating holiday work may also be required. The role includes one week of business-paid travel during training, scheduled for the week of December 14, 2026, as well as occasional travel during the year for training, client or team meetings, conferences, and other business events. The start date is November 30, 2026. No planned time off can be accommodated during the eight-week training period. The RN must hold a current license in good standing in their state of residence and be willing to obtain and maintain a California RN license through endorsement after hire, as well as additional state licenses when required. Licensing and renewal costs are the employee’s responsibility.

Requirements

Associate degree and professional nursing license.
Registered Nurse license in good standing in the state of residence.
Hold or be eligible to obtain a Compact Nursing License where applicable, and be willing to obtain a Compact license if the employee's state adopts Compact legislation.
Obtain and maintain a California RN license through endorsement upon hire and be willing to obtain additional single-state licenses as requested.
Initiate the California licensure endorsement application upon accepting an offer; the employee is responsible for associated licensing and renewal fees.
At least two years of experience in a customer service setting demonstrating advanced issue-resolution skills, preferably in a call center environment.
Ability to research, analyze, prepare reports, and document clearly.
Proficiency in Microsoft Office applications, specifically Excel.
Ability to work in a fast-paced environment and multitask.
Strong written and verbal communication skills.
Advanced problem-solving and troubleshooting skills, including critical thinking.
Strong attention to detail and relationship-building skills, and ability to train other team members.
Comfort with a highly telephonic role, continuous inbound and outbound call-queue work, and remaining at a workstation throughout the workday.

Nice To Haves

Previous experience in the PBM and/or healthcare industry.

Responsibilities

Adhere to principles stipulated by program-specific contractual agreements and company practices.
Demonstrate clinical competency regarding reimbursement, products, and medical records, and review and train other team members on these concepts.
Troubleshoot complex cases, identify trends across disease states, investigate data, and resolve escalated reimbursement issues, including prior authorization denials and appeals.
Review payer product coverage criteria and denial letters to identify documentation required for coverage determinations.
Communicate consistently and effectively with healthcare providers using approved resources about payer coverage criteria and information missing from payer submissions.
Handle inbound and outbound inquiries as a professional resource, collecting data, providing accurate and timely updates, and documenting follow-up calls, patient inquiries, outcomes, clinical notes, and medical record or chart reviews when applicable.
Gather, analyze, and prepare data for Quarterly Business Reviews and client meetings.
Participate in program-specific customer meetings and training sessions.
Report patient adverse drug events in accordance with manufacturer requirements.
Attend manufacturer-hosted conferences, customer meetings, training sessions, and Quarterly Business Reviews as requested, including in-person events requiring travel.
Complete special projects and other assigned duties.