Remote Inpatient UM Clinical Specialist

Cambia Health Solutions; United States; Remote; USD 34,000 - 58,000; Full time

Benefits offered by this job

Work from home options

Bonus target 5%

Job summary

Cambia is seeking a Utilization Management Inpatient Clinical Specialist to support IP UM reviews from a home-based role across WA, OR, ID, or UT. You will verify documentation, research inquiries, and coordinate with licensed clinicians to ensure accurate, timely responses.

The role emphasizes independent work within a fast-paced healthcare environment, with strong emphasis on communication, confidentiality, and adherence to regulatory standards.

Qualifications

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

Responsibilities

• Review IP UM requests and obtain missing details.
• Communicate with providers and team members to complete notifications in compliance.
• Manage time and meet regulatory quality standards for accuracy and timeliness.
• Organize reference documents, policies and procedures, maintaining confidentiality.
• Initiate referrals to adjacent teams as needed.
• Discuss discharge planning with providers when needed.

Skills

Clinical experience

Strong communication

EMR systems

Time management

Independent worker

Education

High school diploma

CMA or CNA preferred

Tools

Microsoft Office

EMR systems

Billing & claims systems

Job description

Cambia is seeking a Utilization Management Inpatient Clinical Specialist to support IP UM reviews from a home-based role across WA, OR, ID, or UT. You will verify documentation, research inquiries, and coordinate with licensed clinicians to ensure accurate, timely responses.

The role emphasizes independent work within a fast-paced healthcare environment, with strong emphasis on communication, confidentiality, and adherence to regulatory standards.