Remote Care Management Nurse: Impactful Health Outcomes

Cambia Health Solutions; Heber (UT); Remote; USD 48,000 - 79,000; Full time

Benefits offered by this job

Medical, dental and vision coverage

401(k) with company match

Paid holidays

Job summary

Cambia Health Solutions is seeking a Remote Care Management Nurse to provide clinical care management, case management, and care coordination from home within Oregon, Washington, Idaho or Utah. The role emphasizes evidence-based practice, policy interpretation, and collaboration with care teams to improve outcomes.

Qualified RNs with at least 3 years of direct clinical care experience and knowledge of health insurance trends are encouraged to apply.

Qualifications

• RN license in the relevant state
• Minimum 3 years direct clinical care or in case management, utilization management, disease management, auditing, or retrospective review
• Knowledge of health insurance trends, technology and contractual arrangements
• Strong communication and customer service skills
• Ability to interpret policies and make decisions within clinical guidelines
• Organizational and time management skills to handle workload independently

Responsibilities

• Provide clinical care management, including case management and care coordination
• Collaborate with members, families, physicians, and other departments to plan and evaluate care
• Ensure compliance with medical policy and medical necessity guidelines
• Maintain accurate documentation and protect confidentiality
• Monitor and adjust care plans based on member needs and outcomes
• Respond to inquiries professionally and coordinate with internal/external stakeholders

Skills

Clinical care

Case management

Communication skills

Time management

Policy interpretation

Education

RN nursing degree or health/human services degree

Tools

Microsoft Office

Health documentation systems

Job description

Cambia Health Solutions is seeking a Remote Care Management Nurse to provide clinical care management, case management, and care coordination from home within Oregon, Washington, Idaho or Utah. The role emphasizes evidence-based practice, policy interpretation, and collaboration with care teams to improve outcomes.

Qualified RNs with at least 3 years of direct clinical care experience and knowledge of health insurance trends are encouraged to apply.