Hybrid Risk Adjustment Provider Educator

at Cambia Health Solutions

• Job title: Risk Adjustment Provider Educator
• Job type: Full Time
• Experience level: Mid level, Senior
• Salary: $83,300 - $111,600 per year
• Degree requirement: Bachelor's Degree
• Location requirements: Hybrid, United States

About the role

• Provider Educator for Cambia’s Risk Adjustment team developing education initiatives for providers across Commercial and Medicare lines. Collaborating with the team to enhance provider engagement and optimize performance.

Responsibilities

• Develops, coordinates, and drives risk adjustment education initiatives with network providers.
• 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 identified as candidates for provider education engagement.
• Work with key leaders within the provider organization to engage with and drive successful performance of the provider engagement.
• Assist senior leadership with special projects related to advancing Cambia’s value-based and innovative provider relationships.
• Participate in definition of project deliverables, providing consultation, recommendations, and solutions.

Requirements

• Bachelor’s degree in a related field.
• At least 5 years of Medicare Advantage or Commercial risk adjustment experience.
• 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.
• Strong consulting, communication (written and verbal), influencing, and facilitation skills.
• Proficiency in using Microsoft Office tools.
• 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.

Benefits

• Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits.
• Annual employer contribution to a health savings account.
• Generous paid time off varying by role and tenure in addition to 10 company-paid holidays.
• Market-leading retirement plan including a company match on employee 401(k) contributions, with a potential discretionary contribution based on company performance (no vesting period).
• Up to 12 weeks of paid parental time off (eligibility requires 12 months of continuous service with Cambia immediately preceding leave).
• Award-winning wellness programs that reward you for participation.
• Employee Assistance Fund for those in need.
• Commute and parking benefits.