Remote Care Manager RN - Impactful Case Management

Cambia Health; Tacoma (WA); Remote; USD 51,000 - 69,000; Full time

Benefits offered by this job

Medical, dental & vision coverage

HSA contributions

Generous PTO

401(k) with match

Parental leave

Wellness programs

Employee assistance fund

Commuting benefits

Job summary

Cambia Health is seeking a Remote Care Management Nurse to join our Clinical Services team. You will provide case, disease, and care coordination management from home across participating states, applying clinical judgment within policy guidelines.

Ideal candidates have 3+ years in direct clinical care with RN licensure and are eligible for licensure in Idaho, Oregon, Utah, and Washington. This role emphasizes quality outcomes and cost-effective care in a supportive, flexible environment.

Qualifications

• Nursing or health/human services degree (Associate's or Bachelor's minimum) or equivalent experience.
• Minimum 3 years of direct clinical care or experience in case management, utilization management, disease management, auditing, or retrospective review.
• Active, unrestricted licensure in a U.S. state or territory enabling independent assessments (RN license for medical care management).
• Must be eligible for licensure in Idaho, Oregon, Utah, and Washington.

Responsibilities

• Conducts case management activities: assessment, planning, implementation, coordination, monitoring and evaluation.
• Applies clinical expertise to ensure compliance with medical policy and guidelines within licensure scope.
• Collaborates with physicians, internal/external customers and departments to resolve issues and participate in quality improvement.
• Serves as a resource to internal/external customers while protecting confidentiality of sensitive information.
• Provides accurate documentation meeting performance standards and timelines.
• Coordinates resources and prioritizes assignments to meet goals and deadlines.
• Monitors and evaluates plan effectiveness and makes adjustments as needed.

Skills

Health insurance trends

Office software

Communication skills

Policy interpretation

Time management

Critical thinking

AI tools experience

Education

Associate's or Bachelor's degree

Tools

Microsoft Office

Outlook

Health care documentation systems

Job description

Cambia Health is seeking a Remote Care Management Nurse to join our Clinical Services team. You will provide case, disease, and care coordination management from home across participating states, applying clinical judgment within policy guidelines.

Ideal candidates have 3+ years in direct clinical care with RN licensure and are eligible for licensure in Idaho, Oregon, Utah, and Washington. This role emphasizes quality outcomes and cost-effective care in a supportive, flexible environment.