Clinical Account Manager - HCA

Cambia Health Solutions • Renton, WA

4d • $101,200 - $115,000 • Hybrid

About The Position

Clinical Account Manager - HCA Hybrid opportunity within Renton, WA. 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 Manager s are living our mission to make health care easier and lives better. As a member of the Washington Health Care Account 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 advance 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 (registered nurse, social worker, or Pharmacist), a dditional qualifications will be considered such as 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., Registered Nurse, MSW, Pharmacist) 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, and maintenance of clinical data, partnering with Healthcare Informatics to meet client needs Analyzes and effectively presents clinical data to customers, providing consulting to improve health plan performance The expected hiring range for the Clinical Account 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 [email protected] . Information about how Cambia Health Solutions collects, uses, and discloses information is available in our .

Requirements

• Clinical license required (e.g., Registered Nurse, MSW, Pharmacist)
• Bachelor's degree in Healthcare, Business or related field (MPH, MHA or MBA preferred)
• 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

Nice To Haves

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

Responsibilities

• 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 client needs
• Analyzes and effectively presents clinical data to customers, providing consulting to improve health plan performance

Benefits

• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level