Remote Care Management Nurse | Health Plan Care Coordination

Cambia Health; Bend (OR); Remote; USD 70,000 - 94,000; Full time

Benefits offered by this job

Work from home options

Generous benefits

Job summary

Cambia Health is seeking a Remote Care Management Nurse to provide case management, disease management, and care coordination from home within Oregon, Washington, Idaho or Utah. Licensure in multiple states is required or eligible.

The role emphasizes clinical expertise, collaboration with physicians and internal teams, and maintaining compliant documentation while supporting member needs.

Qualifications

• Nursing or health/human services degree (Associate's or Bachelor's minimum) or equivalent experience.
• Minimum 3 years of direct clinical care or experience in case management, utilization management, disease management, auditing, or retrospective review.
• Active, unrestricted licensure or certification in a U.S. state or territory.
• Must be eligible for licensure in Idaho, Oregon, Utah, and Washington.

Responsibilities

• Conducts case management activities from assessment to evaluation to identify and meet member needs.
• Applies clinical judgment to ensure compliance with medical policy and standards of care.
• Collaborates with physicians and other departments to resolve claims and quality issues.
• Responds to inquiries professionally while protecting confidentiality.
• Provides accurate documentation and adheres to timelines.
• Coordinates resources and prioritizes assignments to meet goals.
• Monitors effectiveness of case management plans and adjusts as needed.

Skills

Nursing background

Communication skills

Time management

Interpret policies

AI tools experience

Microsoft Office

Education

Nursing degree (Associate/Bachelor)

RN licensure in applicable states

Tools

Microsoft Office

EHR systems

AI tools

Job description

Cambia Health is seeking a Remote Care Management Nurse to provide case management, disease management, and care coordination from home within Oregon, Washington, Idaho or Utah. Licensure in multiple states is required or eligible.

The role emphasizes clinical expertise, collaboration with physicians and internal teams, and maintaining compliant documentation while supporting member needs.