Hybrid Risk Management Manager — Data & Risk Adjustment

Cambia Health; Lewiston (ID); Hybrid; USD 111,000 - 151,000; Full time

Benefits offered by this job

Medical, dental, vision

401(k) plan

Paid time off

Remote work options

Job summary

Cambia Health seeks a Manager, Risk Management Business Team to lead data submissions for Enrollment, Medical and Pharmacy Claims within Risk Adjustment programs. The role blends in-office collaboration (3 days/week) with remote work, across multiple offices including Salt Lake City, Boise, Lewiston, and others.

You will guide validation, translation processes and stakeholder communication. The ideal candidate has a Bachelor's in Business or Data Analysis and 10 years of data analytics or

Qualifications

• Bachelor's degree in Business, Data Analysis or related field.
• 10 years of data analysis, process modeling or equivalent experience.
• Experience with risk adjustment systems and data submissions.

Responsibilities

• Oversee data submission for Enrollment, Medical and Pharmacy Claims.
• Lead a team, validate data against CMS rules, and report metrics.
• Develop underwriting rules reflecting rating strategy and revenue targets.
• Coordinate with IT, compliance, revenue, enrollment, and product teams.
• Provide staff training and mentor performance development.

Skills

Analytical skills

Data analysis

Project management

Leadership

Education

Bachelor's degree in Business or Data Analysis

Job description

Cambia Health seeks a Manager, Risk Management Business Team to lead data submissions for Enrollment, Medical and Pharmacy Claims within Risk Adjustment programs. The role blends in-office collaboration (3 days/week) with remote work, across multiple offices including Salt Lake City, Boise, Lewiston, and others.

You will guide validation, translation processes and stakeholder communication. The ideal candidate has a Bachelor's in Business or Data Analysis and 10 years of data analytics or