Remote Care Management Nurse — Flexible, Impactful RN Role

Cambia Health Solutions; Bellevue (WA); Presencial; USD 47.000 - 77.000; Jornada completa

Descripción de la vacante

Cambia Health Solutions seeks a Remote Care Management Nurse to support care management activities from home across Oregon, Washington, Idaho or Utah. This role involves assessing, planning and coordinating care, with emphasis on quality and cost-effective outcomes.

Requires RN licensure and clinical experience in case/disease management. As part of Clinical Services, you will collaborate with physicians and care teams, utilize AI tools to enhance decisions, and ensure compliant documentation.

Formación

• Nursing or health/human services degree (Associate's or Bachelor's minimum)
• Minimum 3 years of direct clinical care or experience in case management, utilization management, disease management, auditing, or retrospective review
• Active, unrestricted U.S. licensure for independent assessments; RN license required for medical care management

Responsabilidades

• Conducts case management activities: assessment, planning, implementation, coordination, monitoring, and evaluation to meet member needs.
• Applies clinical judgment to ensure compliance with medical policy and guidelines.
• Collaborates with physicians, internal and external customers to resolve claims, quality of care, and provider issues.
• Serves as a resource to internal and external customers, maintaining confidentiality of sensitive information.
• Provides accurate documentation, meeting performance standards and timelines.
• Coordinates resources and prioritizes assignments to meet goals.
• Monitors and evaluates effectiveness of case management plans and adjusts as needed.

Conocimientos

Clinical care experience

Case management

Communication skills

AI tools experience

Microsoft Office

Documentation systems

Educación

Nursing or health/human services degree

Herramientas

Microsoft Office

Health care documentation systems

Descripción del empleo

Cambia Health Solutions seeks a Remote Care Management Nurse to support care management activities from home across Oregon, Washington, Idaho or Utah. This role involves assessing, planning and coordinating care, with emphasis on quality and cost-effective outcomes.

Requires RN licensure and clinical experience in case/disease management. As part of Clinical Services, you will collaborate with physicians and care teams, utilize AI tools to enhance decisions, and ensure compliant documentation.