Remote Care Manager RN – Health Coordination

Cambia Health Solutions; Burlington (WA); On-site; USD 50,000 - 69,000; Full time

Benefits offered by this job

Medical, dental and vision coverage

Paid time off and holidays

Market-leading 401(k) with company mat

Job summary

Cambia Health Solutions is seeking a Remote Care Management Nurse for future opportunities. Work from home within Oregon, Washington, Idaho or Utah; open to current BCBSND employees. The role supports clinical care management, disease management, and care coordination.

RN licensure is required and eligibility for licensure in the listed states is essential. Pay ranges are state-based; hourly rates are provided with a bonus target.

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 license or equivalent in a US state/territory; RN license required for medical care management.
• Eligible for licensure in Idaho, Oregon, Utah, and Washington.

Responsibilities

• Conducts case management activities: assess, plan, implement, coordinate, monitor, evaluate to meet member needs.
• Apply clinical judgment to ensure compliance with medical policy and guidelines.
• Collaborate with physicians, customers, and departments to resolve issues and improve quality of care.
• Provide resource and information support to internal/external customers while protecting confidentiality.
• Document accurately and timely to meet standards and timelines.
• Coordinate resources and prioritize assignments to meet goals.
• Monitor effectiveness of care plans and adjust as needed.

Skills

Health insurance trends

Computer skills

Documentation systems

Communication skills

Policy interpretation

Time management

AI tools exposure

Education

Nursing or health/human services degree

Job description

Cambia Health Solutions is seeking a Remote Care Management Nurse for future opportunities. Work from home within Oregon, Washington, Idaho or Utah; open to current BCBSND employees. The role supports clinical care management, disease management, and care coordination.

RN licensure is required and eligibility for licensure in the listed states is essential. Pay ranges are state-based; hourly rates are provided with a bonus target.