Risk Adjustment Provider Educator
: Job Details :

RISK ADJUSTMENT PROVIDER EDUCATOR Work from home within Oregon, Washington, Idaho or Utah (WA PREFERRED) 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 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. Are you a creative communicator with a passion for educating healthcare providers? Do you have experience in developing engaging content and strategic communications? Then this role may be the perfect fit. 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