Remote Care Management Nurse
Cambia Health Solutions is seeking a Remote Care Management Nurse for future opportunities to provide clinical care management and coordinate patient care. This remote role requires an active RN license and at least 3 years of clinical or case management experience.
Job Description
Role Overview
- Title: Remote Care Management Nurse
- Employer: Cambia Health Solutions
- Location: Remote (Within Oregon, Washington, Idaho, Utah, or North Dakota)
Responsibilities
- Provide clinical care management, including case management, disease management, and care coordination.
- Assess, plan, implement, coordinate, monitor, and evaluate care to meet member needs and promote quality outcomes.
- Apply clinical expertise to ensure compliance with medical policy, medical necessity guidelines, and accepted standards of care.
- Collaborate with physician advisors and internal/external departments to resolve claims, quality of care, and member/provider issues.
- Maintain consistent and accurate documentation meeting corporate goals and compliance standards.
Qualifications
- Nursing or health/human services degree (Associate's or Bachelor's minimum), or equivalent experience in lieu of a degree.
- Minimum 3 years of direct clinical care or experience in case management, utilization management, disease management, auditing, or retrospective review.
- Active, unrestricted RN license required for medical care management.
- Eligibility for licensure in Idaho, Oregon, Utah, and Washington.
Requirements & Skills
Specialty
Case Management
Education
Associate
Experience
3+ years
Licenses
RN
Skills
Case ManagementCare CoordinationDisease ManagementUtilization ManagementPatient AssessmentHealthcare DocumentationCritical Thinking