Healthcare Performance Consultant or Senior Clinical Expert

3 weeks ago


Portland, Oregon, United States Cambia Health Solutions, Inc Full time

Clinical Program Consultant or Senior DOE

Work from home within Oregon, Washington, Idaho or Utah

Travel locally or out of state may be required

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

Who We Are Looking For:

Cambia Health Solutions, Inc. is seeking dedicated professionals to join our team of Clinical Program Consultants. These individuals will utilize their clinical expertise to inform customer recommendations that promote member health and wellbeing while mitigating cost drivers.

We are looking for highly motivated and experienced professionals who can collaborate with internal and external partners to address customer needs, analyze reports, evaluate program deliverables, and offer recommendations. The ideal candidate will have a strong analytical mindset, excellent communication skills, and the ability to work collaboratively with diverse stakeholders.

The successful candidate will also have experience in areas of medical case management for complex cases and utilization management practices. They will be able to translate data into actionable plans and drive continuous improvement. Additionally, they will have a customer mindset and proven ability to build positive relationships, gain trust and respect, and influence others.

Key Responsibilities:

  • Analyze health plan data to understand financial and utilization trends; and present clinical data findings in an easy-to-understand manner to inform customers and advise on opportunities to improve health plan performance.
  • Stay up-to-date on Regence clinical programs, including those for fully insured members and buy-up options for self-funded groups, and educate leadership, colleagues, and business associates on their value proposition.
  • Conduct research and root cause analysis on member, provider, vendor, or process issues, and effectively communicate clinical and process findings to others using self-service report systems.
  • Develop and implement monitoring and control procedures with internal operational leaders to improve work initiatives, track operational achievements, and identify opportunities for improvement.
  • Collaborate with internal and external business partners to collect, analyze, and maintain relevant data, and monitor results and metrics to ensure deliverables are met and compliance with department and regulatory standards.

What You Will Do at Cambia Health Solutions, Inc.:

The selected candidate will work collaboratively with our team to achieve our mission of making healthcare easier and lives better. This includes analyzing health plan data, presenting clinical data findings, conducting research and root cause analysis, developing and implementing monitoring and control procedures, and collaborating with internal and external business partners.

Estimated Salary: $120,000 - $150,000 per year, depending on experience.

About Us:

Cambia Health Solutions, Inc. is a leading healthcare company dedicated to improving health outcomes and wellbeing. We are committed to providing high-quality programs and services that meet the evolving needs of our customers and members.



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