About the role

Lead member engagement programs and long-range risk adjustment planning at Cambia Health. Drive KPIs, partnerships, and team leadership to improve member outcomes and coding accuracy.

Responsibilities

Attract, develop and retain the best talent for Cambia; provide effective leadership and oversight to get the best long-term performance from the team.
Lead the development, planning, implementation and oversight of the performance of member engagement programs, including in-home assessments, direct scheduling with PCPs, mail or digital campaigns.
Collaborate with other member-facing functions to ensure a coordinated approach that engages the member and improves health outcomes and member satisfaction.
Proactively develop KPIs, reporting and tools needed to understand drivers of success or limitations and solve problems; collaborate with Risk Adjustment analytics, Actuary and other areas.
Create a long-range planning function for risk adjustment to ensure appropriate strategic direction and assist the VP, Risk Adjustment in setting expectations for accurate risk coding.
Lead staff providing planning, implementation and KPI reporting support for new strategic initiatives and executive reporting throughout Cambia.
Manage relationships with third-party service providers and lead within a matrix organization.
Provide direction to your team, engage them towards common goals and create a positive experience that helps people flourish.

Bachelor’s degree in Healthcare, Business or related field and 7 years of experience in Healthcare or equivalent combination of education and experience.
5 years’ experience in risk adjustment leadership, including member engagement, program leadership and execution.
3-5 years strategic planning, including development of operational models, financial analysis and external benchmarking.
Demonstrated experience working with third-party service providers and building collaborative working relationships and teams.
Experience leading a matrix structure and having an executive presence.
Experience developing KPIs, reporting and tools to understand drivers of success and solve problems.
Experience collaborating with Risk Adjustment analytics and Actuary functions.
Proven ability to attract, develop and retain talent and provide effective leadership and oversight.
Willingness to collaborate across multiple areas and champion transparency.
Ability to work in an office environment; travel may be required locally or out of state; may be required to work outside normal hours.
Background check required.
Remote work requires wired internet (not satellite/cellular) with minimum upload 5Mb and download 10 Mb.

The expected hiring range for a AD Risk Adj Member Engagement and Planning is $132,600.00 - $179,400.00.
The bonus target for this position is 15%.
Competitive base pay and bonus opportunities.
Market-leading 401(k) with a significant company match and potential discretionary contribution (no vesting period).
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.
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.
Work from home options for most of our roles (requires a wired internet connection that is not satellite or cellular and minimum upload speed of 5Mb and minimum download speed of 10 Mb).