Remote Inpatient UM Clinical Specialist

Cambia Health Solutions; Pocatello (ID); Remoto; USD 37.000 - 60.000; Tempo pieno

Vantaggi offerti da questo lavoro

Competitive salary

Bonus opportunities

Health benefits

401(k) with company match

Descrizione del lavoro

Cambia Health Solutions is seeking a UM IP Clinical Specialist to research and review inpatient utilization requests, collaborate with licensed health professionals, and ensure accurate documentation. The role supports timely, compliant clinical reviews and works with internal and external stakeholders to resolve issues.

The position emphasizes independent work in a fast-paced healthcare environment, with focus on confidentiality, data accuracy, and meeting performance standards.

Competenze

• High school diploma or equivalent.
• Clinical experience is required.
• At least 2 years of clinical experience preferred.
• CMA or CNA preferred.

Mansioni

• Research IP UM requests and ensure information is complete, then take action to close cases efficiently.
• Communicate with providers and team members to facilitate notifications in line with regulatory standards.
• Adhere to timelines and quality requirements for all UM activities and compliance with regulations.
• Organize reference documents, policies, and procedures and maintain confidentiality in a fast-paced environment.
• Perform research and problem-solving to ensure accuracy and contribute to workflow improvements.
• Initiate referrals to adjacent teams as needed.
• Discuss discharge planning with providers when necessary and assist with system testing as appropriate.

Conoscenze

Clinical experience

Communication skills

Computer skills

Medical terminology

EMR documentation

Independent worker

Team collaboration

Formazione

High school diploma or equivalent

CMA or CNA preferred

Strumenti

Microsoft Office

Outlook

EMR systems

Descrizione del lavoro

Cambia Health Solutions is seeking a UM IP Clinical Specialist to research and review inpatient utilization requests, collaborate with licensed health professionals, and ensure accurate documentation. The role supports timely, compliant clinical reviews and works with internal and external stakeholders to resolve issues.

The position emphasizes independent work in a fast-paced healthcare environment, with focus on confidentiality, data accuracy, and meeting performance standards.