Remote Care Management Nurse — Transform Health Outcomes

Cambia Health; Tacoma (WA); A distancia; USD 48.000 - 79.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Remote work

Competitive salary

Bonus potential

401(k) match

Descripción de la vacante

Cambia Health is seeking a Remote Care Management Nurse to provide clinical care management across Oregon, Washington, Idaho, and Utah. The role emphasizes case management, disease management, and care coordination to meet member needs while maintaining compliance with medical policies.

Ideal candidates hold an RN license and have 3+ years of direct clinical or case-management experience, with licensure eligibility in the listed states.

Formación

• Nursing or health/human services degree (associate's or bachelor's minimum)
• Minimum 3 years of direct clinical care or case management related experience
• Active, unrestricted RN license or equivalent for medical care management
• Eligible for licensure in Idaho, Oregon, Utah, and Washington

Responsabilidades

• Conducts case management activities from assessment to evaluation to identify and meet member needs.
• Applies clinical expertise and judgment to ensure compliance with medical policy and guidelines.
• Collaborates with physician advisors, internal/external customers, and other departments to resolve claims and care issues.
• Responds to inquiries professionally while protecting confidential information.
• Provides consistent and accurate documentation within established timelines.
• Coordinates resources, organizes and prioritizes assignments to meet goals and timelines.
• Monitors and evaluates the effectiveness of case management plans and adjusts as needed.

Conocimientos

RN license

Case management

Utilization management

Care coordination

Health insurance knowledge

Educación

Associate's degree

Bachelor's degree

Herramientas

Microsoft Office

Healthcare documentation systems

Descripción del empleo

Cambia Health is seeking a Remote Care Management Nurse to provide clinical care management across Oregon, Washington, Idaho, and Utah. The role emphasizes case management, disease management, and care coordination to meet member needs while maintaining compliance with medical policies.

Ideal candidates hold an RN license and have 3+ years of direct clinical or case-management experience, with licensure eligibility in the listed states.