Remote Care Management RN — Impactful, Work-From-Home

Cambia Health Solutions; Pocatello (ID); On-site; USD 51,000 - 69,000; Full time

Benefits offered by this job

Health benefits

Paid time off

Company 401(k) match

Parental leave

Job summary

Cambia Health Solutions is seeking a Remote Care Management Nurse to support members through case management, disease management, and care coordination. This role offers work-from-home flexibility across Oregon, Washington, Idaho, or Utah with eligibility to practice as an RN in the region.

The position emphasizes clinical expertise, collaboration with physicians, and utilization of health IT tools to improve outcomes while controlling costs.

Qualifications

• RN license or eligible licensure to practice in the US
• Minimum 3 years of direct clinical care or experience in case management, utilization management, disease management, auditing, or retrospective review
• Must be eligible for licensure in Idaho, Oregon, Utah, and Washington

Responsibilities

• Conducts case management activities from assessment to evaluation to identify and meet member needs.
• Applies clinical judgment to ensure compliance with medical policy and guidelines.
• Collaborates with physicians, other departments, and providers to resolve claims and care issues.
• Serves as a resource to customers while protecting confidentiality of sensitive information.
• Provides accurate documentation and adheres to timelines.
• Coordinates resources and prioritizes assignments to meet goals and timelines.
• Monitors and evaluates care plans and makes adjustments as needed.

Skills

Clinical case management

Care coordination

Communication skills

Health IT literacy

AI tools familiarity

Education

Nursing degree or allied health degree

Tools

Microsoft Office

Health care documentation systems

Job description

Cambia Health Solutions is seeking a Remote Care Management Nurse to support members through case management, disease management, and care coordination. This role offers work-from-home flexibility across Oregon, Washington, Idaho, or Utah with eligibility to practice as an RN in the region.

The position emphasizes clinical expertise, collaboration with physicians, and utilization of health IT tools to improve outcomes while controlling costs.