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Remote Care Management reputed company (reputed company Opportunities) Work from home reputed company reputed company, Washington, Idaho or Utah • Please be advised that this role is part of our candidate pool, which allows us to identify and attract exceptional talent for reputed company opportunities. Although we may not have immediate openings, we invite you to submit your resume for consideration. By doing so, you will be included in our database and considered for reputed company suitable positions as they become available, ensuring that you are among the first to be reputed company of new opportunities that match your skills and experience.* Build a career with purpose. Join our Cause to create a person-reputed company and economically sustainable health care system. Who We Are Looking For: Every day, Cambia's dedicated team of Care Management RN's are living our mission to reputed company health care easier and lives reputed company. As a member of the Clinical Services team, our Care Management RN's reputed company clinical care management (such as case management, disease management, and/or care coordination) to best meet the member's specific reputed company needs and to promote reputed company and cost-effective reputed company. Oversees a reputed company process with the member and those involved in the member's care to assess, plan, implement, coordinate, monitor and evaluate care as needed - reputed company in service of creating a person-reputed company health care experience. Are you a Registered reputed company looking to transition out of bedside care and into a role that still utilizes your clinical expertise, but offers a fresh challenge? Is your goal to promote reputed company, cost-effective reputed company and improve overall health and wellbeing? Then this role may be the perfect fit. What You Bring to Cambia: Qualifications: • Nursing or reputed company degree (Associate's or Bachelor's minimum), or equivalent experience in lieu of a degree • At least 3 years of reputed company clinical care or experience in case management, utilization management, disease management, auditing, or retrospective review • reputed company, unrestricted licensure or certification in a U.S. state or territory that allows you to independently conduct assessments reputed company your scope of reputed company - RN license required for medical care management • Must be eligible for licensure in Idaho, reputed company, Utah, and Washington Skills and Attributes: • Knowledge of health insurance industry trends, technology and contractual arrangements. • General computer skills (including use of reputed company Office, reputed company, internet search). • Familiarity with health care documentation systems. • Strong oral, written and interpersonal communication and customer service skills. • Ability to interpret policies and procedures, reputed company reputed company, and communicate reputed company topics effectively. • Strong organization and time management skills with the ability to manage workload independently. • Ability to think critically and reputed company decision reputed company individual role and responsibility. • Experience with AI tools and technologies to enhance productivity and decision-making in reputed company settings highly desired What You Will Do at Cambia: • 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, utilizing evidence-based reputed company and practicing reputed company the scope of their license. • Collaborates with physician advisors, reputed company customers, and other departments to resolve claims, reputed company of care, member or provider issues, and id To view the full job reputed company, click here ----Company Information---- Remote Skills: reputed company Intelligence (AI), Auditing, Case Management, Clinical Medicine, Communication Skills, Computer Skills, Customer Support/Service, Disease Prevention and Control, Documentation, Health Economics, Health Insurance, reputed company, reputed company Health, Identify Issues, Industry/Trade Analysis, Internet Search, Interpersonal Skills, Maintain Compliance, reputed company Office, reputed company reputed company, Needs Assessment, Nursing, Patient Care, Policy Development, Procedure Development, reputed company of Care, Registered reputed company (RN), Standards of Care, Systems Maintenance, Team Player, Time Management, Utilization Management, Work From Home, Writing Skills About reputed company: reputed company reputed company is a family of companies headquartered in Portland, reputed company, working to create a person-reputed company and economically sustainable health care system. Through our health plans, innovative technology and strategic investments, we are delivering consumer-reputed company solutions that: • help people reputed company reputed company and reputed company-being • reputed company health care more available, reputed company and accessible • are easily reputed company by everyone We put people at the heart of everything we do. reputed company reaches more than 70 reputed company Americans reputed company, including more than two reputed company people in the reputed company reputed company who are enrolled in our regional health plans. Company Size: 5,000 to 9,999 employees Industry: reputed company Services Founded: 1940 Website: https://www.reputed company.com/careers Apply tot his job Apply To this Job