Remote Inpatient Utilization Clinical Specialist

Cambia Health Solutions; Salem (OR); Remote; USD 56,000 - 86,000; Full time

Benefits offered by this job

Work from home options

Competitive benefits

401(k) match

Paid time off

Parental leave

Wellness programs

Job summary

Cambia Health Solutions is seeking an UM IP Clinical Specialist to support inpatient utilization management by researching and actioning documentation and requests. You will collaborate with licensed clinicians and internal stakeholders to ensure complete and compliant case reviews, while maintaining high productivity in a fast-paced health-care setting.

The role emphasizes independent work with a strong team orientation, handling citations to CPT, DX, and HCPCS knowledge, and contributing to

Qualifications

• Clinical experience in inpatient utilization management or related field.
• Strong communication and organization skills.
• Ability to work independently with high-volume caseload.

Responsibilities

• Research and review IP UM requests for completeness.
• Communicate with providers and internal stakeholders.
• Meet regulatory and quality requirements.
• Maintain reference documents and procedures.
• Assist with discharge planning discussions as needed.
• Refer to adjacent teams when needed.
• Support systems testing and process improvements.

Skills

Clinical experience

Strong communication skills

EMR navigation

Microsoft Office/Outlook

Documentation & coding knowledge

Education

High school diploma or equivalent

CMA or CNA preferred

Tools

EMR systems

Billing systems

Microsoft Office

Job description

Cambia Health Solutions is seeking an UM IP Clinical Specialist to support inpatient utilization management by researching and actioning documentation and requests. You will collaborate with licensed clinicians and internal stakeholders to ensure complete and compliant case reviews, while maintaining high productivity in a fast-paced health-care setting.

The role emphasizes independent work with a strong team orientation, handling citations to CPT, DX, and HCPCS knowledge, and contributing to