Risk Adjustment Provider Educator

RISK ADJUSTMENT PROVIDER EDUCATOR

Work from home within Oregon , Washington , Idaho or Utah (WA PREFERRED)

Build a career with purpose. Join our to create a person-focused and economically sustainable health care system.

Who We Are Looking For :

Every day, Cambia’s dedicated team of Risk Adjustment Operations is living our mission to make health care easier and lives better.

As a member of the Risk Adjustment Operations Team, as our Risk Adjustment Provider Educator, you'll develop communications, content, and engage network providers to support provider education objectives all in service of making our members’ health journeys easier.

Preferred Key Experience :

Risk Adjustment Experience (MUST HAVE)

Risk Coding - CRC Certification (MUST HAVE)

Network Contracts experience

Value Based Arrangements

Medical Advantage Knowledge

What You Bring to Cambia :

Qualifications :

Bachelor’s degree in a related field

Minimum 5 years of Medicare Advantage or Commercial risk adjustment experience including

Minimum 4 years of experience in a HCC Coding Audit or Network Management role

Equivalent combination of education and experience.

CRC credentials a must

Skills and Attributes :

Strong consulting, communication (written and verbal), influencing, and facilitation skills

Proficiency in using Microsoft Office tools and proven ability to display analytical data and research findings for effective presentations and improved decision making.

Knowledge of health care industry trends, provider relations, and risk adjustment HCC coding, ICD10 diagnosis coding.

Knowledge of health insurance preferred, including medical and dental terminology, procedural and diagnosis coding, reimbursement methodologies and various provider network arrangements.

What You Will Do at Cambia :

• Develops, coordinates, and drives risk adjustment education initiatives with network providers and acts as primary point of contact for assigned key provider engagements across Commercial and Medicare lines of business
• Coordinate outreach, communication, training, and education for providers that have been identified through various operational reporting channels as a candidate for provider education engagement
• Works with key leaders within the provider organization to engage with and drive successful performance of the provider engagement.
• Assists senior leadership with special projects related to advancing Cambia’s value based and innovative provider relationships.
• Participates in definition of project deliverables, providing consultation, recommendations, and solutions, reviewing project mandates and directives to determine overall provider engagement approach
• Leads, under the direction of management, in design and implementation of initiative related administrative policies and procedures and provides guidance and direction to the work team
• The expected hiring range for this position is 90k-100k annually depending on skills, experience, education, and training;

relevant licensure / certifications; and performance history. The bonus target for this position is 10% . The current full salary range for this role is $77k Low Range / $97k MRP / $127k High Range annually.

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 (eligible day one of employment if within first 12 months following birth or adoption).
• Award-winning wellness programs that reward you for participation.
• Employee Assistance Fund for those in need.
• Commute and parking benefits.

Learn more about our .

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 and Affirmative Action employer dedicated to workforce diversity and 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 .

Information about how Cambia Health Solutions collects, uses, and discloses information is available in our .