Remote Utilization Management Nurse | Case Management Expert

Cambia Health Solutions, Inc. is seeking an experienced Utilization Management Nurse to support our Clinical Services team.

This role focuses on prospective, concurrent, and retrospective reviews to ensure medical necessity and cost-effective care across Oregon, Washington, Idaho, and Utah. The role emphasizes collaboration with interdisciplinary teams, application of evidence-based criteria, and thorough documentation to support transitions of care while protecting member confidentiality.