Top 59 Cambia health solutions Jobs

Remote Care Management Nurse
Cambia Health Solutions —Idaho
- $38.00 - $41.50 an hour
- Overtime
- Remote
- Background check
- Nursing
- Microsoft Outlook
- Health insurance
- Dental insurance
Quick Apply
Remote Care Management Nurse
Cambia Health Solutions —Utah
- $38.00 - $41.50 an hour
- Overtime
- Remote
- Background check
- Nursing
- Microsoft Outlook
- Health insurance
- Dental insurance
Quick Apply
Pharmacy Services Technician
Cambia Health Solutions —Lewiston, ID
- $19.20 - $34.90 an hour
- Full-time
- Remote
- Background check
- HIPAA
- Mid-level
- Health savings account
- Paid holidays
Temporary Customer Service Professional I
Cambia Health Solutions —Lewiston, ID
- $19.00 - $22.25 an hour
- Overtime
- Background check
- Basic math
- High school diploma or GED
- Work from home
- Opportunities for advancement
Solutions Architect I or II, DOE - Healthcare Services
Cambia Health Solutions —Portland, OR
- $114,000 - $228,000 a year
- Full-time
- Hybrid work
- Background check
- Computer Science
- System design
- Health savings account
- Paid holidays
Solutions Architect I or II, Corporate Solutions
Cambia Health Solutions —Portland, OR
- $114,000 - $228,000 a year
- Full-time
- Hybrid work
- Background check
- Azure
- Computer Science
- Health savings account
- Paid holidays
Regence Small Group Account Executive
Cambia Health Solutions —Portland, OR
- $65,000 - $107,000 a year
- Full-time
- Hybrid work
- Background check
- Marketing
- Word processing
- Health savings account
- Paid holidays
Solutions Architect I or II, DOE – Customer Acquisition Digital Engineering
Cambia Health Solutions —Portland, OR
- $130,000 - $228,000 a year
- Full-time
- Background check
- Azure
- Computer Science
- Health savings account
- Paid holidays
Associate Medical Director Behavioral Health or Utilization Management Medical Director DOE
Cambia Health Solutions —Lewiston, ID
- $204,000.00 - $369,932.61 a year
- Part-time
- Hybrid work
- Background check
- Medicine
- Psychiatry
- Health savings account
- Paid holidays
ACA Sales Performance Consultant
Cambia Health Solutions —Portland, OR
- $72,000 - $117,000 a year
- Full-time
- Hybrid work
- Background check
- Computer science
- Computer Science
- Health savings account
- Paid holidays
Consulting Research Analyst Or Consulting Research Associate II
Cambia Health Solutions —Portland, OR
- $72,000 - $142,000 a year
- Full-time
- Hybrid work
- Background check
- Bachelor of Science
- Writing skills
- Health savings account
- Paid holidays
Project Coordinator I
Cambia Health Solutions —Salt Lake City, UT
- $23.91 - $42.20 an hour
- Full-time
- Hybrid work
- Background check
- Writing skills
- Analysis skills
- Health savings account
- Paid holidays
Executive Assistant I - Pharmacy
Cambia Health Solutions —Boise, ID
- $59,000 - $97,000 a year
- Full-time
- Hybrid work
- Background check
- Microsoft Excel
- Basic math
- Health savings account
- Paid holidays
Medicare Pharmacy Programs Manager, II, or Sr DOE
Cambia Health Solutions —Boise, ID
- $101,444.41 - $187,737.35 a year
- Full-time
- Hybrid work
- Background check
- 5 years
- Office
- Health savings account
- Paid holidays
Account Executive
Cambia Health Solutions —Boise, ID
- $65,000 - $107,000 a year
- Full-time
- Hybrid work
- Background check
- Marketing
- Word processing
- Health savings account
- Paid holidays
8d
VP of Business Optimization
Cambia Health Solutions —Portland, OR
- $224,000 - $366,000 a year
- Full-time
- Background check
- 11+ years
- Analysis skills
- Health savings account
- Paid holidays
Clinical Account Manager - HCA
Cambia Health Solutions —Renton, WA
- $95,000 - $155,000 a year
- Full-time
- Hybrid work
- Background check
- RN License
- Sales
- Health savings account
- Paid holidays
Mgr, Finance System Services
Cambia Health Solutions —Portland, OR
- $114,000 - $186,000 a year
- Full-time
- Hybrid work
- Background check
- Computer Science
- 5 years
- Health savings account
- Paid holidays
Network Innovations Program Manager, Primary Care Programs
Cambia Health Solutions —Portland, OR
- $104,000 - $150,700 a year
- Full-time
- Hybrid work
- Background check
- Primary Care
- Master's degree
- Health savings account
- Paid holidays
Supervisor Utilization Management
Cambia Health Solutions —Lewiston, ID
- $80,717 - $142,000 a year
- Full-time
- Hybrid work
- Background check
- Nursing
- RN License
- Health savings account
- Paid holidays

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Remote Care Management Nurse

Cambia Health Solutions -
Idaho

Quick Apply

Job Details

Full-time
$38.00 - $41.50 an hour

Benefits

Health insurance
Dental insurance
401(k)
Flexible spending account
Tuition reimbursement
Paid time off
Employee assistance program
Vision insurance
401(k) matching
Flexible schedule
Life insurance
Referral program

Qualifications

Microsoft Outlook
RN License
Customer service
Writing skills
Health insurance policy knowledge
Case management
Utilization management
Decision making
Industry trends
Clinical documentation
Time management

Full Job Description

Care Management Nurse
Remote within WA, OR, ID, UT. Candidates outside of these states will not be considered.

Primary Job Purpose

The Care Management Nurse provides clinical care management (such as case management, disease management, and/or care coordination) to best meet the member’s specific healthcare needs and to promote quality and cost-effective outcomes. Oversees a collaborative process with the member and those involved in the member’s care to assess, plan, implement, coordinate, monitor and evaluate care as needed.

General Functions and Outcomes

Responsible for essential activities of case management including assessment, planning, implementation, coordination, monitoring and evaluation.
Assessment: collection of in-depth information about a member’s situation and functioning to identify individual needs.
Planning: identification of specific objectives, goals, and actions designed to meet the member’s needs as identified in the assessment.
Implementation: execution of the specific case management activities that will lead to accomplishing the goals set forth in the plan.
Coordination: organization, securing, integrating and modifying resources.
Monitoring: gathering sufficient information to determine the plan’s effectiveness and the evaluation phase should determine the effectiveness of reaching the desired outcomes.
Applies clinical expertise and judgment to ensure compliance with medical policy, medical necessity guidelines, and accepted standards of care.
Utilizes evidence-based criteria that incorporates current and validated clinical research findings. Practices within the scope of their license.
Consults with physician advisors to ensure clinically appropriate determinations.
Serves as a resource to internal and external customers.
Collaborates with other departments to resolve claims, quality of care, member or provider issues.
Identifies problems or needed changes, recommends resolution, and participates in quality improvement efforts.
Responds in writing or by phone to members, providers and regulatory organizations in a professional manner while protecting confidentiality of sensitive documents and issues.
Provides consistent and accurate documentation.
Plans, organizes and prioritizes assignments to comply with performance standards, corporate goals, and established timelines.

Minimum Requirements

Knowledge of health insurance industry trends, technology and contractual arrangements.
General computer skills (including use of Microsoft Office, Outlook, internet search). Familiarity with health care documentation systems.
Strong oral, written and interpersonal communication and customer service skills.
Ability to interpret policies and procedures, make decisions, and communicate complex topics effectively.
Strong organization and time management skills with the ability to manage workload independently.
Ability to think critically and make decision within individual role and responsibility.

Normally to be proficient in the competencies listed above

Care Management Nurse would have a/an Associate or Bachelor’s Degree in Nursing or related field and 3 years of case management, utilization management, disease management, or behavioral health case management experience or equivalent combination of education and experience.

Required Licenses, Certifications, Registration, Etc.

Must have licensure or certification, in a state or territory of the United States, in a health or human services discipline that allows the professional to conduct an assessment independently as permitted within the scope of practice for the discipline (e.g. medical vs. behavioral health) and at least 3 years (or full time equivalent) of direct clinical care

Must have at least one of the following: Certification as a case manager from the URAC-approved list of certifications; or Bachelor’s degree (or higher) in a health or human services-related field (psychiatric RN or Master’s degree in Behavioral Health preferred for behavioral health care management); or Registered nurse (RN) license (must have a current unrestricted RN license for medical care management)

The expected hiring range for a Care Management Nurse is $38.00 - $41.50 an hour depending on skills, experience, education, and training; relevant licensure / certifications; and performance history. The bonus target for this position is 10% .  The current full salary range for this role is $33.80 - $55.00 an hour.

At Cambia, we take a variety of factors into account when creating a job offer, including your skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. While we offer competitive salaries, in general, we do not hire candidates at or near the top of the pay range.

We are an Equal Opportunity and Affirmative Action employer dedicated to workforce diversity and a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required.

If you need accommodation for any part of the application process because of a medical condition or disability, please email [email protected]
. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy
. As a health care company, we are committed to the health of our communities and employees during the COVID-19 pandemic. Please review the policy on our Careers
site.

Job Type: Full-time

Pay: $38.00 - $41.50 per hour

Expected hours: 40 per week

Benefits:

401(k)
401(k) matching
Dental insurance
Employee assistance program
Flexible schedule
Flexible spending account
Health insurance
Life insurance
Paid time off
Referral program
Tuition reimbursement
Vision insurance

Supplemental Pay:

Bonus opportunities
Overtime pay

Application Question(s):

Do you have a valid RN license in ID, OR, WA or UT?
Do you have at least 3 years clinical experience working directly with patients?

Location:

Idaho (Required)

Work Location: Remote

Quick Apply

Refine Your Search

cambia health solutions jobs

Remote Care Management Nurse

Remote Care Management Nurse

Pharmacy Services Technician

Temporary Customer Service Professional I

Solutions Architect I or II, DOE - Healthcare Services

Solutions Architect I or II, Corporate Solutions

Regence Small Group Account Executive

Solutions Architect I or II, DOE – Customer Acquisition Digital Engineering

Associate Medical Director Behavioral Health or Utilization Management Medical Director DOE

ACA Sales Performance Consultant

Consulting Research Analyst Or Consulting Research Associate II

Project Coordinator I

Executive Assistant I - Pharmacy

Medicare Pharmacy Programs Manager, II, or Sr DOE

Account Executive

VP of Business Optimization

Clinical Account Manager - HCA

Mgr, Finance System Services

Network Innovations Program Manager, Primary Care Programs

Supervisor Utilization Management

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