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Risk Adjustment Provider Educator

Cambia Health Solutions

Burlington, WA

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JOB DETAILS
JOB TYPE
Full-time, Employee
SKILLS
Administrative Policies, Analysis Skills, Auditing, Communication Skills, Consulting, Content Development, Health Economics, Health Insurance, Healthcare, ICD-10, Industry/Trade Analysis, Leadership, Loans, Medical Coding, Medicare, Microsoft Office, Network Administration/Management, Network Support, Organizational Skills, People Management, Problem Solving Skills, Provider Relations, Reimbursement, Risk, Systems Maintenance, Team Player, Training/Teaching, Willing to Travel
ADDITIONAL COMPENSATION
0
LOCATION
Burlington, WA
POSTED
30+ days ago
Provider Educator

Work a Hybrid schedule within Oregon, Washington, Idaho or Utah

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 Provider Educators is living our mission to make health care easier and lives better. As a member of the Risk Adjustment team, our Provider Educators are responsible for developing communications, content and engaging network providers in support of provider education objectives. - all in service of creating a person-focused health care experience.

Do you have a passion for serving others and learning new things? Do you thrive as part of a collaborative, caring team? Then this role may be the perfect fit.

What You Bring to Cambia:

Qualifications:

* Provider Education Coordinator would have a Bachelor's degree in a related field and at least 5 years of Medicare Advantage or Commercial risk adjustment experience including at least 4 years of experience in a HCC Coding Audit or Network Management role or equivalent combination of education and experience.

* CPC and/or CRC credentials preferred

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

Work Environment

* No unusual working conditions.
* Work primarily performed in an office environment.
* Some travel may be required

The expected hiring range for a Provider Educator is $83,300.00 - $111,600.00 depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. The bonus target for this position is 10%. The current full salary range for this role is $78,000.00 to $128,000.00.

#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 h

About the Company

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Cambia Health Solutions

Cambia Health Solutions is a family of companies headquartered in Portland, Oregon, working to create a person-focused and economically sustainable health care system. Through our health plans, innovative technology and strategic investments, we are delivering consumer-centric solutions that: • help people achieve better health and well-being • make health care more available, affordable and accessible • are easily understood by everyone We put people at the heart of everything we do. Our company reaches more than 70 million Americans nationwide, including more than two million people in the Pacific Northwest who are enrolled in our regional health plans.
COMPANY SIZE
5,000 to 9,999 employees
INDUSTRY
Healthcare Services
FOUNDED
1940
WEBSITE
https://www.cambiahealth.com/careers