Oncology Care Management Nurse

🔥 9 minutes ago

🥔 Idaho, Oregon, +2 more states – Remote

🥔 Idaho – Remote 🌲 Oregon – Remote ⛷️ Utah – Remote ☕ Washington – Remote

💵 $31 - $51 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 0%

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Cambia Health Solutions

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

🏥 Healthcare

⚕️ Healthcare Insurance

🤝 Non-profit

Healthcare • Healthcare Insurance • Non-profit

Cambia Health Solutions is a nonprofit, mission-driven healthcare company based in Portland, Oregon, that operates consumer-focused health care and health insurance businesses and invests in health innovation. It serves as the parent organization for the Regence family of health plans and runs initiatives and subsidiaries focused on improving care delivery, providing insurance products, and developing digital health tools and services.

📋 Description

• Provide clinical care management, including case management, disease management, and/or care coordination • Assess, plan, implement, coordinate, monitor, and evaluate member care • Promote quality and cost-effective healthcare outcomes • Conduct case management activities to identify and meet member needs • Apply clinical expertise and judgment to ensure compliance with medical policy, medical necessity guidelines, accepted standards of care, and license scope • Collaborate with physician advisors, internal and external customers, and other departments • Resolve claims, quality of care, member, and provider issues • Identify problems or needed changes, recommend resolutions, and participate in quality improvement efforts • Serve as a resource to internal and external customers and respond professionally to inquiries • Protect confidentiality of sensitive documents and issues • Provide consistent and accurate documentation in compliance with performance standards, corporate goals, and timelines • Coordinate resources and prioritize assignments to meet goals and timelines • Monitor and evaluate case management plan effectiveness and adjust plans as needed

🎯 Requirements

• 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 licensure or certification in a U.S. state or territory allowing independent assessments within scope of practice • RN license required for medical care management • Must be eligible for licensure in Idaho, Oregon, Utah, and Washington • Knowledge of health insurance industry trends, technology, and contractual arrangements • General computer skills, including Microsoft Office, Outlook, and internet search • Familiarity with health care documentation systems • Strong oral, written, 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; ability to manage workload independently • Critical thinking and decision-making within role and responsibility • Experience with AI tools and technologies highly desired • Wired internet connection that is not satellite or cellular, with minimum 5 Mb upload and 10 Mb download speeds • Access to a personal mobile device for MFA • Successful background check • Must reside within Oregon, Washington, Idaho, or Utah

🏖️ Benefits

• Competitive salary • Bonus opportunities; 8% bonus target • Medical, dental and vision coverage for employees and eligible family members, including mental health benefits • Annual employer contribution to a health savings account • Generous paid time off varying by role and tenure • 10 company-paid holidays • Market-leading retirement plan including company match on employee 401(k) contributions • Potential discretionary 401(k) contribution based on company performance, with no vesting period • Up to 12 weeks of paid parental time off, subject to eligibility • Award-winning wellness programs that reward participation • Employee Assistance Fund • Commute and parking benefits • Work-from-home options • Wired internet connection and minimum internet speeds required for work-from-home option • Employee resource groups • Cambia-supported community outreach programs • Personal mobile device access for Multi-Factor Authentication

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