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You will be updated with latest job alerts via emailEvery day Cambias dedicated team of Care Management Nurses and Clinicians are living our mission to make health care easier and lives better. As a member of the Care Management team our Care Management Nurses and Clinicians provide clinical care management to best meet the members specific healthcare needs and to promote quality and cost-effective outcomes all in service of making our members health journeys easier.
Do you enjoy working collaboratively with members and their multidisciplinary care team to ensure their needs are being met and voices are being heard Do you enjoy staying current with the latest clinical practices and guidelines in your field to ensure members care is top tier Then this role may be the perfect fit.
Associate or Bachelors Degree in Nursing
Registered nurse (RN) license (must have a current unrestricted RN license) BSN strongly preferred.
3 years of case management utilization management disease management or behavioral health case management experience
Equivalent combination of education and experience.
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.
Masters degree in Behavioral Health related field with a current unrestricted independent clinical license (ex. LCSW LICSW LMHC LPC or LMFT)
3 years of case management utilization management disease management or behavioral health case management experience
Experience working in an Integrated Behavioral Health-Medical model preferred
Equivalent combination of education and experience.
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.
Knowledge of health insurance industry trends technology and contractual arrangements.
Proficiency in general computer skills including Microsoft Office Outlook and internet search.
Strong oral written and interpersonal communication and customer service skills.
Ability to interpret policies and procedures make clinical 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 decisions within individual role and responsibility.
Patient-focused approach to problem solving prioritizing optimal health outcomes for each member.
Drive member behavior change health coach/lifestyle modification social determinants of health remediation intensive coordinated transitions of care engagement of family members and direct collaborative provider engagement.
Serve as the individuals single point of contact with no (or few) handoffs to other disciplines.
Assesses four potential problem domains including medical behavioral social and health system using a holistic approach.
Identify an individuals barriers to health improvement and compliance by utilizing a narrative relationship-based approach to assessing health complexity.
Leverage the individuals motivation for change and create prioritized interventions based on the individuals goals.
Establishing and measuring outcomes based on care plan goals as well as clinical functional economic and quality of life outcomes.
Responsible for essential activities of case management including assessment planning implementation coordination monitoring and evaluation.
#LI-Remote
The expected hiring range for a Integrated Care Management Nurse or Clinician is $42.00 - $44.00 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 $34.20 - $55.70 an hour.
About Cambia
Working at Cambia means being part of a purpose-driven award-winning culture built on trust and innovation anchored in our 100 year history. Our caring and supportive colleagues are some of the best and brightest in the industry innovating together toward sustainable person-focused health care. Whether were helping members lending a hand to a colleague or volunteering in our communities our compassion empathy and team spirit always shine through.
Why Join the Cambia Team
At Cambia you can:
We believe a career at Cambia is more than just a paycheck and your compensation should be too. Our compensation package includes competitive base pay as well as a market-leading 401(k) with a significant company match bonus opportunities and more.
In exchange for helping members live healthy lives we offer benefits that empower you to do the same. Just a few highlights include:
Learn more about our benefits.
We are happy to offer work from home options for most of our roles. To take advantage of this flexible option we require employees to have a wired internet connection that is not satellite or cellular and internet service with a minimum upload speed of 5Mb and a minimum download speed of 10 Mb.
We are an Equal Opportunity employer dedicated to 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 . Information about how Cambia Health Solutions collects uses and discloses information is available in our .
Full-Time