Remote Care Management Nurse (RN) — Transform Patient Care

Cambia Health Solutions, Inc.; Spokane (WA); Remote; USD 48,000 - 79,000; Full time

Benefits offered by this job

Health insurance

401(k) plan

Paid time off

10 company-paid holidays

Parental leave

Wellness programs

Employee Assistance Fund

Commuting benefits

Job summary

Cambia Health Solutions is seeking a Clinical Care Management RN to provide case management, disease management and care coordination for members across Oregon, Washington, Idaho and Utah.

You'll work from home with preference for Idaho and Utah residents; licensure in required states and unrestricted RN license; 3+ years clinical experience. Salary ranges and bonus are provided for regional and national structures.

Qualifications

• 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 RN licensure and eligibility for licensure in Idaho, Oregon, Utah and Washington

Responsibilities

• Conduces case management activities: assessment, planning, implementation, coordination, monitoring and evaluation
• Apply clinical expertise to ensure compliance with medical policy and guidelines
• Collaborate with physicians, internal/external teams to resolve claims and improve quality of care
• Serve as a resource to customers while protecting confidentiality
• Provide accurate documentation and meet timelines
• Coordinate resources and prioritize assignments to meet goals
• Monitor effectiveness of case management plans and adjust as needed

Skills

RN license

Clinical care management

Case management

Utilization management

AI tools experience

Communication skills

Time management

Interdisciplinary collaboration

Decision making

Education

Nursing or health/human services degree

Tools

Microsoft Office

Health care documentation systems

Job description

Cambia Health Solutions is seeking a Clinical Care Management RN to provide case management, disease management and care coordination for members across Oregon, Washington, Idaho and Utah.

You'll work from home with preference for Idaho and Utah residents; licensure in required states and unrestricted RN license; 3+ years clinical experience. Salary ranges and bonus are provided for regional and national structures.