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Clinical Account Manager - HCA

Cambia Health Solutions

Renton, WA

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JOB DETAILS
JOB TYPE
Full-time, Employee
SKILLS
Analysis Skills, Artificial Intelligence (AI), Business Administration, Business Case, Business Development, Business Strategy, Case Management, Clinical Competency, Clinical Data, Clinical Support, Communication Skills, Competitive Research, Content Management Systems (CMS), Contingency Plans, Customer Experience, Customer Relations, Data Analysis, Health Economics, Health Insurance, Health Plan, Healthcare, Healthcare Effectiveness Data and Information Set (HEDIS), Healthcare Providers, Industry/Trade Analysis, Leadership, Licensed Practical Nurse/Licensed Vocational Nurse, Market Trend Analysis, Multitasking, Network Management Software, Presentation/Verbal Skills, Problem Solving Skills, Program Evaluation, Program Planning, Project/Program Management, Registered Nurse (RN), Regulatory Requirements, Sales Management, Strategic Accounts, Strategic Planning, Systems Maintenance, Team Player, Time Management, Underwriting, Utilization Management
LOCATION
Renton, WA
POSTED
30+ days ago
Clinical Account Manager - HCA

Hybrid opportunity within Renton, WA; Vancouver, WA; Burlington, WA; Portland, OR; Medford, OR; Lewiston, ID; Boise, ID; Salt Lake City, UT

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 dedicated team of Clinical Account Managers are living our mission to make health care easier and lives better. As a member of the [team name] team, our Clinical Account Manager serves as a strategic clinical liaison for one of our largest customer groups, collaborating across internal teams to evaluate, present, and implement clinical programs and solutions that align with the customer's multiyear business strategy. This role provides ongoing consultative support by leveraging clinical expertise and data insights to recommend care management solutions that improve member health outcomes and productivity while meeting customer objectives - all in service of creating a person-focused health care experience.

Do you have a passion for translating clinical expertise into strategic solutions that improve member health outcomes? Do you thrive in a collaborative environment where you partner across teams to deliver innovative care management programs? Then this role may be the perfect fit.

What You Bring to Cambia:

Qualifications:

* Clinical Account Manager would have a clinical license (licensed practical nurse or registered nurse), Bachelor's degree in Healthcare, Business or related field (MPH, MHA or MBA preferred) and 8 years of case management, utilization management, or behavioral case management, including program management, sales or consulting experience, or equivalent combination of education and experience.

Skills and Attributes:

* Proven ability to develop and maintain strategic account relationships with customers and internal stakeholders, serving as a proactive, consultative partner who advances customer goals while aligning with health plan business strategies

* Demonstrated experience leading collaborative strategic planning, creating financial business cases, and ensuring successful operational execution of clinical programs

* Strong communication and presentation skills with the ability to influence, advocate, and unite colleagues to achieve customer objectives

* Knowledge of health insurance industry trends, clinical case management, utilization management practices, and regulatory requirements (CMS, state, HEDIS)

* Ability to evaluate program effectiveness, identify opportunities for improvement, and manage multiple projects within time constraints

* Strong data analysis skills with the ability to abstract, interpret, and translate complex data into actionable plans and solutions

* Clinical license required (e.g., Licensed Practical Nurse or Registered Nurse)

* Experience with AI tools and technologies to enhance productivity and decision-making highly desired

What You Will Do at Cambia:

* Ensures clear understanding of client clinical needs and proactively recommends strategies, programs, and contingency plans to achieve business objectives while anticipating potential obstacles

* Displays an enthusiastic, self-directed approach while leveraging internal resources (Provider Network Management, Healthcare Services, Underwriting) and developing strong relationships with key stakeholders and vendors

* Monitors business/industry conditions, customer developments, and competitive activities to stay ahead of market trends

* Ensures alignment of systems and end-to-end processes to support new programs and optimize outcomes and member experience

* Collaborates with internal and external partners on collection, analysis, an
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About the Company

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Cambia Health Solutions

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