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What You Will Do at Cambia: Own and deliver end-to-end product domains- Take full ownership of your assigned data and analytics product area, from vision and backlog management through delivery, adoption, and measurable business outcomes. Skills and Attributes: Technical credibility - working fluency in SQL and modern data platforms (Snowflake preferred), dimensional modeling concepts, and BI/visualization tools (SIGMA a plus, or the drive to learn it immediately).

YEAR

Cambia Health

Product Manager, Hedis Data & Agentic

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What You Will Do at Cambia: Own and deliver end-to-end product domains - Take full ownership of your assigned data and analytics product area, from vision and backlog management through delivery, adoption, and measurable business outcomes. Skills and Attributes: Technical credibility - working fluency in SQL and modern data platforms (Snowflake preferred), dimensional modeling concepts, and BI/visualization tools (SIGMA a plus, or the drive to learn it immediately).

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.  

Cambia Health Solutions Inc

Product Manager, HEDIS Data & Agentic

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FULL_TIME

This role is accountable for ensuring accurate cost allocation, improving data reliability, and driving performance against key Equipment Support KPIs that directly impact project cost and execution. The CE&I segment generates over $4.5 billion in annual revenue, providing construction services across our renewables, industrial, infrastructure, and general building operating groups.

CEI Services

Equipment Support Manager

[AW]-iCims

Wanzek Construction

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Jacobs Solutions Inc

Senior Design Manager Data Center

Prepares and manages timely and accurate project documents and status reports, estimates, projections, material release schedules, client information, project schedules, purchase orders, monthly invoices, payments, closeout documents, warranties, drawings, maintenance manuals, final billings, change orders, cost codes and other documentation to support construction project work. Responsible to manage multiple projects of varying sizes and complexities from start to finish, including proposals, bids, project design, quality control, job scheduling, problem resolution, job completion, coordination, communication, client satisfaction activities and other related duties, in alignment with all Company policies, procedures, key objectives and regulations.

ArchKey Solutions LLC

Project Manager- Construction Technologies

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Job Description: The Regional Reimbursement Director (RRD) is field-based job with local responsible for the overall management of the reimbursement environment for all Ipsen products within the Neuroscience therapeutic area in the healthcare provider channel as well as managing relationships with local Medicare Administrative Contractors (MACs). Collaborate with the Ipsen Value & Access home office and field teams, sales teams, brand teams, and the IPSEN CARES Patient support hub to expand access and/or reduce barriers to access for Ipsen's Neurology products.

ImCheck Therapeutics SAS

Regional Reimbursement Director, Neuroscience, North Central

Ipsen SA

OTHER

In support of TRICARE beneficiaries enrolled in the Autism Care Demonstration (ACD), the Autism Services Navigator (ASN) collaborates and oversees the assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services for TRICARE beneficiaries diagnosed with autism spectrum disorder (ASD). • Current unrestricted licensure in an appropriate state or territory of the United States, as a Licensed Independent Clinical Social Worker (LICSW), Licensed Clinical Social Worker (LCSW), Registered Nurse, or other licensed mental health professionals who possess a Certification in Case Management (CCM).

TriWest Healthcare Alliance

Autism Services Navigator

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Technical Skills: Thorough knowledge of policies and procedures, knowledge of managed care principles and methods; medical terminology; proficiency in the application of clinical criteria: InterQual, International Classification of Diseases, Diagnostic and Statistical Manual of Mental Disorders, current Procedural Terminology, and Healthcare Common Procedural Coding System, and American Dental codes; working knowledge with medical management systems; proficient with Microsoft Office; knowledge of UM Process; reporting techniques. • Prepares work schedules and monitors staff caseloads to ensure adequate staffing levels at all times and accurate data entry and application of the medical management system.

Supervisor, Utilization Management

Identifies trends in provider coding/documentation and vendor risk adjustment reporting and makes those trends known to leadership as well as coding team manager and training lead to develop intervention strategies - all in service of creating a person-focused health care experience. As a member of the Risk Adjustment team, our The Risk Adjustment Auditor performs Retrospective/Prospective chart review utilizing various types of records to ensure accurate risk adjustment reporting.

HOUR

QA Risk ADj Auditor II

QA Risk Adj Auditor II

Routinely handles cases that are sensitive or high profile, those that are complex cases involving or cases involving multiple perpetrators or intricate healthcare fraud schemes. Demonstrates high level of knowledge and expertise during interactions and acts confidently when providing testimony during civil and criminal proceedings.

<p>CVS Health offers a world of promising job opportunities across a diverse range of careers in everything from corporate and pharmacy roles to retails positions. No matter where you work at CVS Health, your unique skills, talents and abilities are welcome and valued. We recognize and reward greatness and want our employees to know their work is making a difference in the lives of millions. Join us today. Together we can continue making innovative, high-quality health and pharmacy services safe, affordable and accessible – for all. </p>

CVS Health Corp

Senior Investigator, Special Investigations Unit (Aetna SIU)

The CDS utilizes the hospital's designated clinical documentation system to identify opportunities for physician and hospital outcomes, provides or coordinates education to all internal customers related to compliance, coding, and clinical documentation issues and acts as a consultant to coders when additional information or documentation is needed to assign the correct diagnosis related group (DRG). Graduate from a nationally accredited nursing program preferred, including, but not limited to, Commission on Collegiate Nursing Education (CCNE), Accreditation Commission for Education in Nursing (ACEN), and National League for Nursing Commission for Nursing Education Accreditation (NLN CNEA).

Sanford Health

RN Clinical Documentation Specialist

RN - Clinical Documentation Specialist

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Applies clinical knowledge to make determinations for preauthorization, inpatient and continued stay reviews for Behavioral Health and Medical/Surgical requests to establish medical necessity, benefit coverage, appropriateness of quality of care, and length of stay or care plan. The Utilization Management Clinical Review nurse reviews and makes decisions about the appropriateness and level of beneficiary care being provided in an effort to provide cost effective care and ensure proper utilization of resources.

Utilization Clinical Reviewer

In this role, you will be responsible for analyzing, programming, debugging, building, deploying, testing, and documentation of applications in development and production environments, as well as database design and system testing and documentation. Expected deliverables include requirement analysis, system analysis, system design, data models, program design, source code development, unit test case development, unit and system testing, and documentation.

Data Platform Engineer III (Hedis Support)

Data Platform Engineer III (HEDIS Support)

What You Will Do at Cambia: Collaborate closely with Provider Services, Network Management, corporate business support, operations staff and others to ensure negotiated provider and institutional payments are implemented correctly and promptly. As a member of the Provider Reimbursement team, our Pricing and Reimbursement Analysts analyze, develop, and maintain contract payment terms and reimbursement rates for institutional, facility, and professional healthcare providers across all regions and Regence subsidiaries.

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Product Manager, Hedis Data & Agentic Cambia Health

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QA Risk Adj Auditor II Cambia Health

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RN - Clinical Documentation Specialist Sanford Health

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Data Platform Engineer III (Hedis Support) Cambia Health

Data Platform Engineer III (HEDIS Support) Cambia Health Solutions Inc

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Pricing Reimbursement Analyst I or II Cambia Health Solutions Inc

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