Clinical Program Manager
Work from home within Oregon, Washington, Idaho or Utah
Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system.
Who We Are Looking For:
Every day, Cambia's UMP Clinical Program Manager is living our mission to make health care easier and lives better. As a member of the Health Care Authority team, the UMP Clinical Program Manager leads and manages clinical programs and relationships with HCA clinical staff. This role involves overseeing program execution, ensuring regulatory compliance, and serving as a clinical expert. The manager will participate in key meetings and build strong relationships with the HCA clinical team to drive successful outcomes and maintain regulatory compliance - all in service of making our members' health journeys easier.
Are you a strategic thinker and enjoy aligning clinical programs with organizational goals and objectives? Do you thrive as part of a collaborative, caring team? Then this role may be the perfect fit.
What You Bring to Cambia:
Qualifications:
UMP Clinical Program Manager would have a Bachelor's degree in Nursing or related field, 3 years of experience in a clinical and/or operational environment and 5 years account management or customer management experience or equivalent combination of education and experience.
Required Licenses, Certifications, Registration, Etc.
Current RN or LPN license to practice in Washington State
Skills and Attributes:
Healthcare Industry Knowledge: Comprehensive understanding of the healthcare industry and related benefit products and services.
Autonomy and Prioritization: Ability to work independently with effective prioritization and time management.
Collaboration and Teamwork: Demonstrated team player with ability to organize teams to achieve a common goal.
Communication and Presentation: Excellent verbal and written communication skills, including presentation skills.
Analytical and Problem-Solving: Demonstrated analytical skills to identify problems, develop solutions, and implement a chosen course of action.
Care Management and Account Expertise: Familiarity with Care Management practice and protocols, and experience working directly with clients or external stakeholders.
Policy and Contract Analysis: Ability to analyze and interpret policies and contracts, with a focus on identifying key terms, conditions, and implications, and to negotiate and resolve complex issues with diplomacy and persuasiveness.
What You Will Do at Cambia:
Primary Point of Contact: Serve as the primary point of contact for HCA/UMP Clinical Staff and Regence medical management team for all HCA/UMP clinical programs and issues.
Contract Compliance: Ensure all clinical deliverables and requirements in the UMP contract are met and resolve any escalated clinical issues.
Program Leadership: Lead and manage various clinical programs, with a specific focus on Care Management programs and services.
Clinical Strategy and Planning: Serve as the clinical lead, managing Clinical Strategies meetings and related work, and coordinate with Health Informatics, ASO team, and Regence support staff.
Reporting and Documentation: Ensure all standard reports, activity reports, points of contact, calendar of events, meetings, agendas, and minutes are maintained and completed.
Collaboration and Communication: Attend various meetings with HCA/UMP clinical staff, and work directly with the operations and reporting analyst to support clinical work for UMP.
Team Participation: Actively participate on the ASO Medical Management team, contributing to the development and implementation of clinical programs and initiatives.
The expected hiring range for the UMP Clinical Program Manager is $115,000 - $122,000 depending on skills, experience, education, and training; relevant licensure / certifications; and performance history. The bonus target for this position is 15%. The current full salary range for this role is $86,000 - $141,000. #LI-remote
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 we're 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:
Work alongside diverse teams building cutting-edge solutions to transform health care.
Earn a competitive salary and enjoy generous benefits while doing work that changes lives.
Grow your career with a company committed to helping you succeed.
Give back to your community by participating in Cambia-supported outreach programs.
Connect with colleagues who share similar interests and backgrounds through our employee resource groups.
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:
Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits.
Annual employer contribution to a health savings account.
Generous paid time off varying by role and tenure in addition to 10 company-paid holidays.
Market-leading retirement plan including a company match on employee 401(k) contributions, with a potential discretionary contribution based on company performance (no vesting period).
Up to 12 weeks of paid parental time off (eligibility requires 12 months of continuous service with Cambia immediately preceding leave).
Award-winning wellness programs that reward you for participation.
Employee Assistance Fund for those in need.
Commute and parking benefits.
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 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 CambiaCareers@cambiahealth.com. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy.
