Remote Inpatient Utilization Management Specialist

Cambia Health Solutions; Yakima (WA); Remote; USD 53,000 - 72,000; Full time

Job summary

Cambia Health Solutions is seeking an UM IP Clinical Specialist to support inpatient utilization management processes. This role partners with licensed health professionals and reviews documentation from multiple sources to inform non-clinical actions and ensure efficient clinical reviews.

The position emphasizes accuracy, timeliness, and compliance in a fast-paced healthcare environment. Responsibilities include researching IP UM requests, coordinating with providers and internal stakeholders,

Qualifications

• High school diploma or equivalent required.
• Clinical experience is required.
• At least 2 years of clinical experience preferred; CMA or CNA preferred.
• Strong communication skills, both oral and written, with healthcare staff.

Responsibilities

• Review IP UM requests and research documentation to obtain necessary details.
• Communicate effectively with providers and internal stakeholders to complete role functions.
• Ensure timeliness and accuracy to meet regulatory and quality requirements.
• Organize and maintain reference documents, policies, and procedures.
• Perform research and problem-solve to support IP UM case accuracy and continuous improvement.
• Discuss discharge planning with providers as needed.

Skills

Clinical experience

Communication skills

EMR documentation

Education

High school diploma or equivalent

CMA or CNA preferred

Tools

EMR systems

Microsoft Office

Job description

Cambia Health Solutions is seeking an UM IP Clinical Specialist to support inpatient utilization management processes. This role partners with licensed health professionals and reviews documentation from multiple sources to inform non-clinical actions and ensure efficient clinical reviews.

The position emphasizes accuracy, timeliness, and compliance in a fast-paced healthcare environment. Responsibilities include researching IP UM requests, coordinating with providers and internal stakeholders,