UMP Clinical Program Manager - HCA

Cambia Health Solutions

Renton, WA

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JOB DETAILS

SALARY

$101,200–$115,000 Per Year

JOB TYPE

Full-time, Employee

SKILLS

Analysis Skills, Artificial Intelligence (AI), Communication Skills, Documentation, Establish Priorities, Health Economics, Health Informatics, Health Plan, Healthcare, Identify Issues, Internet/Online Service, Leading Edge Technology, Licensed Practical Nurse/Licensed Vocational Nurse, Loans, Maintain Compliance, Negotiation Skills, Nursing, Policy Analysis, Presentation/Verbal Skills, Problem Solving Skills, Project/Program Management, Registered Nurse (RN), Regulatory Compliance, Sales Management, Systems Maintenance, Team Player, Time Management, Utilization Management, Writing Skills

LOCATION

Renton, WA

POSTED

30+ days ago

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

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 of health plan 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.

Medical Policy Analysis: Ability to analyze and interpret complex medical policies and contracts, with a focus on identifying key terms, conditions, and patient implications.

Care Management/Utilization Management: Familiarity with Care Management and Utilization Management practice and protocols

Account Management: Excellent verbal and written communication skills, including training and presentation skills. Ability to negotiate and resolve complex issues with diplomacy and persuasiveness.

Analytical and Problem-Solving: Demonstrated analytical skills to identify problems, develop solutions, and implement a chosen course of action. Skilled at building and maintaining detailed documentation/audit trails to support compliance obligations.

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.

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

What You Will Do at Cambia:

Serve as a primary point of contact for HCA/UMP Clinical Staff and Regence medical management team for all HCA/UMP clinical programs and issues.

Ensure all clinical deliverables and requirements in the UMP contract are met and resolve any escalated clinical issues.

Lead and manage various clinical programs, with a specific focus on Care Management programs and services.

Partner with existing Regence Clinical Program and Account Managers in managing Clinical Strategies meetings and related work, and coordinate with Health Informatics, ASO team, and Regence support staff.

Ensure all standard reports, activity reports, points of contact, calendar of events, meetings, agendas, and minutes are maintained and completed.

The expected hiring range for the UMP Clinical Program Manager - HCA is $101,200 - $115,000 depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. The bonus target for this position is 15%. The current full salary range for this role is $95,000 - $155,000. #LI-hybrid

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 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 CambiaCareers@cambiahealth.com. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy.\n \nApply here: https://www.aplitrak.com/?adid=YmJnZW5lcmljLjc3NTU5Ljg3NjlAY2FtYmlhaGVhbHRoY29tcC5hcGxpdHJhay5jb20

About the Company

Cambia Health Solutions

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