Remote Inpatient UM Clinical Specialist

Cambia Health Solutions; Idaho; Remote; USD 37,000 - 60,000; Full time

Benefits offered by this job

Health insurance

401(k) plan

Paid time off

Bonus opportunities

Remote work option

Job summary

Cambia Health Solutions is seeking an UM IP Clinical Specialist to support inpatient utilization management. You will research and act on IP UM requests, coordinate with licensed clinicians, and ensure timely, compliant case handling across multiple locations through a remote work setup.

The role emphasizes independent work with high-volume caseloads, strong communication, and proficiency in EMR systems, with focus on accuracy and confidentiality.

Qualifications

• High school diploma or equivalent is required.
• Clinical experience required, inpatient preferred.
• CMA or CNA preferred per role.
• Experience with EMRs and healthcare documentation helpful.

Responsibilities

• Research and review IP UM requests, obtaining missing information.
• Communicate with providers and team members; prepare written notifications.
• Maintain timeliness and compliance with regulatory and quality standards.
• Organize reference documents and maintain a professional environment.
• Initiate referrals to adjacent teams as needed.
• Discuss discharge planning with providers when needed.

Skills

Clinical experience

Inpatient setting

Effective communication

EMR navigation

Time management

Research and analysis

Education

High school diploma

CMA or CNA preferred

Tools

EMR systems

Microsoft Office

Billing/claims software

Job description

Cambia Health Solutions is seeking an UM IP Clinical Specialist to support inpatient utilization management. You will research and act on IP UM requests, coordinate with licensed clinicians, and ensure timely, compliant case handling across multiple locations through a remote work setup.

The role emphasizes independent work with high-volume caseloads, strong communication, and proficiency in EMR systems, with focus on accuracy and confidentiality.