Benefit Contracts & Compliance Analyst

Cambia Health Solutions; Salem (OR); Remote; USD 60,000 - 82,000; Full time

Job summary

Join Cambia Health Solutions as a Benefit Contract Analyst, where you will play a crucial role in developing and managing member enrollment materials. This position involves coordinating compliance filings, ensuring adherence to federal and state regulations, and collaborating with diverse teams to optimize health care delivery. If you possess strong organizational, communication, and analytical skills, this opportunity allows you to contribute meaningfully to a sustainable health care system while working from home within select states.

Benefits

Medical, dental and vision coverage

401(k) with company match

Paid time off and holidays

Comprehensive wellness programs

Paid parental time off

Qualifications

• Bachelor's degree in a relevant field and 3 years of experience or equivalent.
• Experience with federal laws and guidelines like COBRA, HIPAA, ERISA.
• Knowledge of health insurance industry and compliance issues.

Responsibilities

• Research, draft, and file collateral for multiple divisions.
• Coordinate regulatory filings to ensure compliance with laws.
• Negotiate and produce contracts for various lines of business.

Skills

Organizational Skills

Communication Skills

Negotiation Skills

Technical Skills

Analytical Skills

Education

Bachelor's Degree in Healthcare

Bachelor's Degree in Business

Bachelor's Degree in Communications

Job description

Work from home within Oregon, Washington, Idaho, or Utah

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

Who We Are Looking For :

Every day, Cambia’s dedicated team of Benefit Contract Analysts are living our mission to make health care easier and lives better. As a member of the Benefit Contracts Compliance team, our Benefit Contract Analysts are accountable for the development of Member enrollment materials (including, but not limited to, booklets, contracts and Summary of Benefit Changes (SBCs) – all in service of making our members’ heath journeys easier. As a Benefit Contract Analyst, you will coordinate the filing of regulatory documents with the insurance division and analyze insurance division objections and organizes responses and resubmission functions.

Do you have a passion for serving others and learning new things? Then this role may be the perfect fit.

What You Bring to Cambia :

Qualifications :

Benefit Contracts Analyst would have a Bachelor's Degree in Healthcare, English, business or health care administration, communications and 3 years work-related experience or equivalent combination of education and experience.

Skills and Attributes :

Must possess strong organizational skills with a demonstrated ability to prioritize, coordinate and implement multiple projects within varied or simultaneous time constraints.

Ability to coordinate activities with all levels of staff within the Plan and external agencies through clear and concise verbal and written communication skills, including tactful and persuasive negotiation skills.

Ability to work independently and exercise sound judgment while developing solid working relationships with internal and external business partners, including, but not limited to, Sales, Sales Operations, Product and the Insurance Division.

Ability to comprehend, master and draft all aspects of the Plan’s contracts / booklets, benefits administration, and overall business processes for all lines of business / products including group specific or custom groups.

Demonstrated technical skills necessary to effectively navigate the electronic publishing system used for document creation.

Ability to work in high-pressure circumstances on multiple concurrent projects involving multidisciplinary, unconnected tasks, and proven ability to initiate and independently produce detailed and highly accurate work.

Knowledge of the health insurance industry, including benefit design and compliance issues with capability of incorporating into contracts and other related materials.

Experience / understanding and knowledge of federal laws and guidelines (including but not limited to COBRA, HIPAA, ERISA, USERRA, DOL. etc.) and applicable state insurance code and regulations, including the Affordable Care Act (ACA).

What you will do a Cambia :

Research, draft, produce and file collateral for use by operations support, marketing, and sales divisions.

Regulatory filing and maintenance to ensure that all required product documents comply with federal and state laws, including state insurance code requirements, prior to submission with the Insurance Department, and serve as a resource to other divisions.

Negotiate and coordinate with internal and external business partners to develop, write, revise, file, and coordinate the production of contracts and certificates of coverage for all lines of business.

Investigate and respond to contract interpretation requests, ensuring proper administration across divisions.

Establish and maintain an effective working relationship with the Insurance Department to facilitate regulatory compliant form filings.

Access and navigate the electronic publishing system used for creation of member contracts / booklets / plan documents / summary plan descriptions.

Collaborate with other divisions to develop new products and modify existing ones, ensuring competitiveness and efficient service to clients.

No unusual working conditions.

Work primarily performed remotely.

Travel may be required, locally or out of state.

May be required to work overtime.

May be required to work outside normal hours.

The expected hiring range for a Benefit Contacts & Compliance Analyst is $60,000 - $82,000 / year depending on skills, experience, education, and training; relevant licensure / certifications; and performance history. The bonus target for this position is 5%. The current full salary range for this role is $57,000 - $94,000 / year.

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 hand to a colleague or volunteering in our communities, our compassion, empathy and team spirit always shine through.

Why Join the Cambia Team?

At Cambia, you can :

• Work alongside diverse teams building cutting-edge solutions to transform health care.
• Earn a competitive salary and enjoy generous benefits while doing work that changes lives.
• Grow your career with a company committed to helping you succeed.
• Give back to your community by participating in Cambia-supported outreach programs.
• Connect with colleagues who share similar interests and backgrounds through our employee resource groups.

We believe a career at Cambia is more than just a paycheck – and your compensation should be too. Our compensation package includes competitive base pay as well as a market-leading 401(k) with a significant company match, bonus opportunities and more.

In exchange for helping members live healthy lives, we offer benefits that empower you to do the same. Just a few highlights include :

• 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 (eligible day one of employment if within first 12 months following birth or adoption).
• Award-winning wellness programs that reward you for participation.
• Employee Assistance Fund for those in need.
• Commute and parking benefits.

Learn more about our .

We are happy to offer work from home options for most of our roles. To take advantage of this flexible option, we require employees to have a wired internet connection that is not satellite or cellular and internet service with a minimum upload speed of 5Mb and a minimum download speed of 10 Mb.

We are an Equal Opportunity and Affirmative Action employer dedicated to workforce diversity and a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required.

If you need accommodation for any part of the application process because of a medical condition or disability, please email . Information about how Cambia Health Solutions collects, uses, and discloses information is available in our .