Remote Care Management Nurse Cambia Health SolutionsRemote Care Management NurseAhtanum, WARemoteFull timeAs a member of the Clinical Services team, our Care Management RN's provide 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 - all in service of creating a person-focused health care experience.
Pharmacy Services Technician Cambia Health Solutions IncPharmacy Services TechnicianWARemote$20.50–$30.80 / hourAssist with auditing and investigations of medication-related claims, cases, and providers to identify misuse of medications, misuse of resources, substance abuse, and erroneous and fraudulent billing practices; investigate and organize workflow for claims referred to Pharmacy Services for review and allowable determination including miscellaneous J codes, providers on review, and reconsiderations. Support wellness and disease state management programs for Pharmacy Service and corporately which contribute to NCQA accreditation and ongoing quality improvement; contribute to and support the corporation's quality initiatives through process improvement teams and by encouraging team and individual contributions toward quality improvement efforts.
Temporary Customer Service Professional I Cambia Health Solutions IncTemporary Customer Service Professional IWARemote$19–$22.25 / hour6 months of customer service call center experience; or 6 months of customer service experience in insurance, retail, banking, hospital, medical office or similar industry with extensive customer contact; or equivalent combination of education and experience. As the face of Cambia, our CSPs play multiple roles - listener, problem-solver, investigator and advocate - all in service of making our members' health journeys easier and days brighter.
NewPayment Integrity Nurse I Cambia Health Solutions IncPayment Integrity Nurse IYakima, WARemote$73,230.90–$99,077.10 / yearAs a member of the Post Service Claim Review team, our Payment Integrity Nurse I conducts post service review of claims in prepayment, post payment or audit capacity to ensure appropriate clinical review, reimbursement of claims and accuracy of coding. Excellent computer skills and proficiency working software programs (i.e. Microsoft Word, Excel, and PowerPoint); learn new processes and systems quickly.
Insurance Sales Representative (Remote/1099/Commission Only)) The Lyons AgencyInsurance Sales Representative (Remote/1099/Commission Only))Granger, WARemoteNo insurance experience is required—training is provided—but success comes to those who are disciplined, self-starters, and willing to follow a proven system. This is a remote, work-from-home role offering flexible hours and the chance to grow a long-term career in the insurance industry.
Life Insurance Sales Representative (Remote/1099/Commission Only)) The Lyons AgencyLife Insurance Sales Representative (Remote/1099/Commission Only))Wapato, WARemoteNo insurance experience is required—training is provided—but success comes to those who are disciplined, self-starters, and willing to follow a proven system. This is a remote, work-from-home role offering flexible hours and the chance to grow a long-term career in the insurance industry.
Clinical Pharmacist Consultant or Sr. DOE Cambia Health Solutions IncClinical Pharmacist Consultant or Sr. DOEYakima, WARemote$128,145.07–$173,372.75 / yearAs a member of the Pharmacy Services team, our Clinical Pharmacist Consultants provide professional and clinical pharmacy expertise in making or guiding clinical decisions based on best practices by creating and applying evidence-based medicine evaluations to determine the best quality medication choices that represent the best value in efficacy, safety and affordability. Additional responsibilities may include development of position papers, medication coverage policies, formulary monographs and class reviews, cross-functional projects, and/or initiatives related to the provision of pharmacy benefits that impact safety, quality and affordability - all in service of creating a person-focused health care experience.
Associate Medical Director Behavioral Health or Utilization Management Medical Director DOE Cambia Health Solutions IncAssociate Medical Director Behavioral Health or Utilization Management Medical Director DOEYakima, WARemote$217,171.97–$293,820.91 / yearDevelops and Implements Behavioral Health Policies and Programs: Assists in developing high-quality, market-competitive behavioral health medical policies and programs, and provides leadership in developing short and long-range plans, goals, and objectives for integrated utilization management. Subject Matter Expert and Clinical Leadership: Serves as a subject matter expert on behavioral health, provides medical advice, oversight, and leadership for staff, and ensures members receive safe, effective, and cost-efficient services.