Provider Education Specialist in Risk Adjustment

2 weeks ago

Salt Lake, Utah, United States Cambia Health Solutions Full time

Provider Education Specialist in Risk Adjustment

Remote position available for candidates in Oregon, Washington, Idaho, or Utah (Washington Preferred)

Join our mission to create a patient-focused and financially viable healthcare system.

Who We Are Looking For:

At Cambia, our dedicated Risk Adjustment Operations team is committed to streamlining healthcare and enhancing lives. As a Provider Education Specialist in Risk Adjustment, you will develop communications and engage with network providers to elevate educational objectives, ultimately facilitating smoother health journeys for our members.

Essential Qualifications:

Experience in Risk Adjustment (REQUIRED)Certification in Risk Coding - CRC (REQUIRED)Familiarity with Network ContractsUnderstanding of Value-Based Care ModelsKnowledge of Medicare Advantage

What You Bring to Cambia:

Requirements:

Bachelor's degree in a relevant disciplineAt least 5 years of experience in Medicare Advantage or Commercial risk adjustmentA minimum of 4 years in HCC Coding Audit or Network ManagementCRC certification is mandatory

Skills and Competencies:

Excellent consulting, communication, influencing, and facilitation abilitiesProficient in Microsoft Office and data analysis for impactful presentationsAwareness of healthcare industry trends, provider relations, and coding practicesPreferential knowledge of health insurance and provider network structures

Your Responsibilities at Cambia:

Lead educational initiatives related to risk adjustment with network providersOrganize training sessions and outreach for selected providersCollaborate with provider leadership to boost engagementSupport special projects aimed at enhancing provider relationshipsParticipate in defining project deliverables and providing strategic recommendationsPlay a vital role in implementing administrative policies

The anticipated salary range for this role is $90k-$100k annually, with a 10% bonus target. The complete salary range is $77k Low Range / $97k MRP / $127k High Range annually.

About Cambia

Joining Cambia means becoming part of a purpose-driven, innovative culture built on trust and reliability stemming from our 100+ year legacy. Our caring colleagues are industry leaders working together towards sustainable, patient-centered healthcare.

Why Choose Cambia?

At Cambia, you can:

Collaborate with diverse teams on innovative healthcare solutionsReceive competitive compensation and benefits while making a positive impactAdvance your career with a company dedicated to your growthEngage in outreach programs supported by CambiaConnect with colleagues through employee resource groups

Cambia values your contributions beyond just a salary. Our compensation package includes competitive pay, a leading 401(k) plan with employer match, bonus opportunities, and more.

Benefits encompass medical, dental, and vision coverage, employer HSA contributions, paid time off, retirement plans, paid parental leave, wellness programs, and additional perks.

Flexible remote work options are available for most positions, subject to specific internet requirements. Cambia is an Equal Opportunity and Affirmative Action employer.

If you require accommodations during the application process due to a medical condition or disability, please reach out to us.

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