Remote Care Management Nurse (RN) - Make Care Count

Cambia Health Solutions; Utah; Remote; USD 48,000 - 79,000; Full time

Benefits offered by this job

Market-leading 401(k)

Bonus opportunities

Generous paid time off

12 weeks parental leave

Medical, dental and vision coverage

Job summary

Cambia Health Solutions is seeking a Remote Care Management Nurse to support members from home across Oregon, Washington, Idaho or Utah. The role leverages clinical expertise in case management and care coordination to promote quality and cost-effective outcomes.

The position requires an RN license and a relevant degree, with a minimum of 3 years of direct clinical care or case management experience. We offer a national and regional pay structure with competitive benefits and a strong 401(k)

Qualifications

• RN license required in the applicable state.
• Minimum 3 years of direct clinical care or experience in case management, utilization management, disease management, auditing, or retrospective review.
• Nursing or health/human services degree (Associate's or Bachelor's minimum).
• Knowledge of health insurance industry trends and technology.

Responsibilities

• Conducts case management activities, including assessment, planning, implementation, coordination, monitoring, and evaluation to identify and meet member needs.
• Collaborates with physician advisors, internal and external customers, and other departments to resolve claims, quality of care, member or provider issues, and identifies problems or needed changes, recommending resolutions and participating in quality improvement efforts.
• Provides consistent and accurate documentation, ensuring compliance with performance standards, corporate goals, and established timelines.
• Monitors and evaluates the effectiveness of case management plans, gathering sufficient information to determine the plan's effectiveness and making adjustments as needed.

Skills

Communication skills

Time management

Interpersonal skills

Policy interpretation

Customer service

Education

Nursing or health/human services degree (Associate's or Bachelor's minimum)

Tools

Microsoft Office

Outlook

EMR systems

Job description

Cambia Health Solutions is seeking a Remote Care Management Nurse to support members from home across Oregon, Washington, Idaho or Utah. The role leverages clinical expertise in case management and care coordination to promote quality and cost-effective outcomes.

The position requires an RN license and a relevant degree, with a minimum of 3 years of direct clinical care or case management experience. We offer a national and regional pay structure with competitive benefits and a strong 401(k)