Clinical Account Manager - HCA
$101.2k - $115kCambia Health Solutions
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 HCA 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.
- 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
- 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, and maintenance of clinical data, partnering with Healthcare Informatics to meet market needs
- Analyzes and effectively presents clinical data to customers, providing consulting to improve health plan performance
- Collaborates with internal program contacts, external resources, and customers to test, develop, and implement clinical programs while resolving design and implementation challenges
- 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.
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 View email address on click.appcast.io. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy.
Vacancy posted 6 days ago
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