Remote Oncology Care Manager RN

Cambia Health Solutions, Inc.; Renton (WA); Remote; USD 51,000 - 69,000; Full time

Benefits offered by this job

Medical, dental and vision coverage

Generous paid time off and holidays

401(k) with company match

Job summary

Cambia Health Solutions, Inc. is hiring a Care Management RN to provide case management, disease management and care coordination for members across the Northwest.

The role supports a person-focused health care experience while collaborating with physicians, internal teams and external partners. The position offers work-from-home options in many states (WA, OR, ID, UT) and requires an active RN license plus eligibility for licensure in the listed states.

Qualifications

• Nursing or health/human services degree (Associate's or Bachelor's minimum).
• Minimum 3 years of direct clinical care or experience in case management, utilization management, disease management, auditing, or retrospective review.
• Active, unrestricted RN license in a U.S. state or territory that allows you to independently conduct assessments — RN license required for medical care management.
• Must be eligible for licensure in Idaho, Oregon, Utah, and Washington.

Responsibilities

• Conducts case management activities, including assessment, planning, implementation, coordination, monitoring, and evaluation to identify and meet member needs.
• Applies clinical expertise and judgment to ensure compliance with medical policy, medical necessity guidelines, and accepted standards of care.
• Collaborates with physician advisors, internal and external customers, and other departments to resolve claims, quality of care, member or provider issues, and identifies problems or needed changes, recommending resolutions and participating in quality improvement efforts.
• Serves as a resource to internal and external customers, responding to inquiries in a professional manner while protecting confidentiality of sensitive documents and issues.
• Provides consistent and accurate documentation, ensuring compliance with performance standards, corporate goals, and established timelines.
• Coordinates resources, organizes, and prioritizes assignments to meet goals and timelines.
• Monitors and evaluates the effectiveness of case management plans, gathering sufficient information to determine the plan's effectiveness and making adjustments as needed.

Education

Nursing or health/human services degree

Tools

Microsoft Office

Job description

Cambia Health Solutions, Inc. is hiring a Care Management RN to provide case management, disease management and care coordination for members across the Northwest.

The role supports a person-focused health care experience while collaborating with physicians, internal teams and external partners. The position offers work-from-home options in many states (WA, OR, ID, UT) and requires an active RN license plus eligibility for licensure in the listed states.