Medicare Advantage Risk Adjustment Specialist

Cambia Health Solutions; Spokane (WA); Hybrid; USD 62,900 - 97,000; Full time

Benefits offered by this job

Medical, dental and vision coverage

Health savings account contribution

Generous paid time off

Market-leading retirement plan

Paid parental time off

Wellness programs

Employee Assistance Fund

Commute and parking benefits

Job summary

Cambia Health Solutions is seeking a Risk Adjustment Campaign Associate to support Medicare Advantage and Commercial risk adjustment campaigns. This hybrid role requires three days in the office and targets monitoring vendor performance, reporting, and documentation across multiple campaigns.

You'll collaborate with the Risk Adjustment operations team to ensure timely, compliant, and quality-driven campaign execution, using AI tools to boost productivity where appropriate.

Qualifications

• Bachelor’s degree in business, healthcare, or related field with 2+ years in a project support role
• PM certificate is a plus
• CPC or CRC certification is a plus

Responsibilities

• Monitor daily vendor performance against project schedule.
• Support preparation of project reports and presentation of information to management, project teams, and client/customer groups.
• Monitor project documentation for compliance with standards.
• Develop and maintain the overall project documentation library ensuring that all documentation is established, maintained and retained as necessary in project databases.
• Apply continuous quality improvement techniques and methodologies to all facets of job responsibility.
• May plan and manage small, well‑defined projects or sub‑projects under the general direction of more senior project managers.
• May retrieve medical records for MA and ACA campaigns through internal EMR access based on production goals set by the manager of Risk Adjustment Campaigns.

Skills

MS Office

Analytical thinking

Project management

Contract interpretation

SLA monitoring

Communication skills

AI tools

Education

Bachelor’s degree in business/healthcare/related field

Certificate in Project Management

CPC/CRC certification

Tools

Microsoft Office

Job description

Cambia Health Solutions is seeking a Risk Adjustment Campaign Associate to support Medicare Advantage and Commercial risk adjustment campaigns. This hybrid role requires three days in the office and targets monitoring vendor performance, reporting, and documentation across multiple campaigns.

You'll collaborate with the Risk Adjustment operations team to ensure timely, compliant, and quality-driven campaign execution, using AI tools to boost productivity where appropriate.