Remote Care Management RN — Health Plan Impact

Cambia Health Solutions, Inc.; Portland (OR); Remote; USD 51,000 - 69,000; Full time

Benefits offered by this job

Medical benefits

Paid time off

401(k)

Job summary

Cambia Health Solutions, Inc. is hiring a Care Management RN to provide clinical care management, including case management, disease management, and care coordination, for members.

You will oversee a collaborative process with the member and care team to assess, plan, implement, and evaluate care to improve health outcomes. The role supports transitioning from bedside care to a clinically-focused position, emphasizing quality and cost-effective care.

Qualifications

• Nursing degree or health/human services degree minimum
• Active, unrestricted RN license for medical care management or equivalent experience
• Eligible for licensure in ID, OR, UT and WA

Responsibilities

• Conducts case management activities including assessment, planning, implementation, coordination, monitoring, and evaluation
• Apply clinical expertise to ensure compliance with policy and guidelines
• Collaborate with physicians and departments to resolve claims and quality of care issues
• Provide responsive, confidential service to internal/external customers
• Document accurately and meet timelines
• Coordinate resources and prioritize assignments
• Monitor effectiveness of case management plans and adjust as needed

Skills

RN license

Care management

Utilization management

Communication skills

Health IT familiarity

Education

Associate's or Bachelor's in Nursing

Tools

Microsoft Office

Electronic Health Records (EHR)

Job description

Cambia Health Solutions, Inc. is hiring a Care Management RN to provide clinical care management, including case management, disease management, and care coordination, for members.

You will oversee a collaborative process with the member and care team to assess, plan, implement, and evaluate care to improve health outcomes. The role supports transitioning from bedside care to a clinically-focused position, emphasizing quality and cost-effective care.