Remote Care Management Clinician (RN)

Cambia Health Solutions, Inc.; Heber (UT); Remote; USD 48.000 - 79.000; Vollzeit

Benefits dieser Stelle

Health insurance

401(k) with company match

Paid time off

Holidays

Parental leave

Work from home options

Zusammenfassung

Cambia Health Solutions, Inc. is seeking a Care Management Clinician to deliver clinical care management from home across Idaho, Oregon, Utah, and Washington. You will assess, plan, coordinate and monitor member care to improve outcomes and reduce costs.

Requires nursing or related degree plus 3 years of case management experience; licensure; strong communication; familiarity with health insurance trends; benefits include 401(k) with company match, health/dental/vision, PTO, and paid holidays.

Qualifikationen

• Must have licensure or certification in a health or human services discipline and 3 years of direct clinical care.
• Associate or Bachelor's in Nursing or related field; RN license preferred.
• Knowledge of health insurance industry trends and contractual arrangements.
• Strong communication and interpersonal skills; ability to explain complex topics.
• Ability to manage workload independently and interpret policies and procedures.
• Experience with case management, utilization management, or behavioral health management.

Aufgaben

• Provide clinicalCare management through assessment, planning, implementation, coordination, monitoring and evaluation.
• Collaborate with physicians and other departments to resolve issues and ensure appropriate care.
• Document plans accurately and meet performance standards and timelines.
• Apply clinical judgment using evidence-based criteria to ensure medical policy compliance.
• Respond to members, providers and regulators professionally and securely.

Kenntnisse

Organization

Time management

Communication

Customer service

Decision making

Interpreting policies

Ausbildung

Associate or Bachelor’s Degree in Nursing

Related health field degree

Tools

Microsoft Office

Health care documentation systems

Jobbeschreibung

Cambia Health Solutions, Inc. is seeking a Care Management Clinician to deliver clinical care management from home across Idaho, Oregon, Utah, and Washington. You will assess, plan, coordinate and monitor member care to improve outcomes and reduce costs.

Requires nursing or related degree plus 3 years of case management experience; licensure; strong communication; familiarity with health insurance trends; benefits include 401(k) with company match, health/dental/vision, PTO, and paid holidays.