Remote Care Management Clinician – Make Health Easier

Cambia Health Solutions, Inc.; Eagle (ID); Remote; USD 48,000 - 79,000; Full time

Benefits offered by this job

Work from home options

Competitive benefits

Job summary

Cambia Health Solutions, Inc. is seeking a Care Management Clinician to provide clinical care management, case management, and care coordination for members across Idaho, Oregon, Utah, and Washington.

The role emphasizes strong organization, policy interpretation, and patient-centered outcomes. Responsibilities include assessment, planning, and collaboration with physicians and care teams to improve quality and cost efficiency while working in a flexible remote setup within defined states.

Qualifications

• Associate or Bachelor’s degree in Nursing; 3 years of case management experience.
• Current, unrestricted RN license or equivalent health professional license.
• URAC case management certification or higher degree in health field or relevant license.

Responsibilities

• Perform case management activities: assessment, planning, implementation, coordination, monitoring and evaluation.
• Apply clinical judgment to ensure medical policy compliance and appropriate standards of care.
• Consult with physician advisors to ensure determinations and serve as a resource to customers.
• Collaborate with other departments to resolve claims and quality of care issues.
• Identify problems and recommend resolutions; participate in quality improvement efforts.
• Communicate professionally with members, providers, and regulators while protecting confidential information.

Skills

Health insurance industry knowledge

Microsoft Office

Interpersonal communication

Policy interpretation

Time management

AI tools experience

Education

Associate’s or Bachelor’s Degree in Nursing

RN license (unrestricted)

URAC case management certification or health-related degree

Tools

Microsoft Office

EHR systems

Outlook

Job description

Cambia Health Solutions, Inc. is seeking a Care Management Clinician to provide clinical care management, case management, and care coordination for members across Idaho, Oregon, Utah, and Washington.

The role emphasizes strong organization, policy interpretation, and patient-centered outcomes. Responsibilities include assessment, planning, and collaboration with physicians and care teams to improve quality and cost efficiency while working in a flexible remote setup within defined states.