Remote Inpatient Utilization Specialist (Clinical)

Cambia Health Solutions; Boise (ID); Remote; USD 37,000 - 60,000; Full time

Benefits offered by this job

Medical, dental and vision coverage

Health Savings Account (HSA)

Paid time off

Retirement plan with company match

12 weeks of paid parental leave

Wellness programs

Employee Assistance Fund

Commute and parking benefits

Job summary

Cambia Health Solutions seeks a UM IP Clinical Specialist to support inpatient utilization management by researching requests, coordinating with licensed clinicians, and ensuring accurate case documentation and timely actions.

The role emphasizes collaboration with clinical staff, adherence to regulatory standards, and efficient case handling in a fast-paced healthcare insurance environment.

Qualifications

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

Responsibilities

• Research and review IP UM requests and take action to obtain details.
• Communicate with internal and external stakeholders to accomplish role functions.
• Ensure compliance with regulatory and quality standards in all work.

Skills

Clinical experience

Communication skills

EMR navigation

Medical terminology & coding

Independent work

Education

High school diploma or equivalent

CMA or CNA preferred

Tools

Microsoft Office

Outlook

EMR systems

Job description

Cambia Health Solutions seeks a UM IP Clinical Specialist to support inpatient utilization management by researching requests, coordinating with licensed clinicians, and ensuring accurate case documentation and timely actions.

The role emphasizes collaboration with clinical staff, adherence to regulatory standards, and efficient case handling in a fast-paced healthcare insurance environment.