Provider Reimbursement Systems Analyst

Cambia Health Solutions; Boise (ID); Hybrid; USD 93,000 - 125,000; Full time

Job summary

Cambia Health Solutions is seeking a Provider Reimbursement Systems Analyst for a hybrid role with three days in the office. You will design, configure, and test functional data flows and system requirements to support Cambia's core strategies while collaborating across teams.

The role requires strong SQL, testing expertise, and the ability to translate complex business needs into practical system designs; familiarity with Tableau and APIs is a plus.

Qualifications

• College degree is desired in Computer Sciences, Mathematics, Business Administration, or related fields.
• Minimum five years' experience in defining and analyzing business requirements, process modeling, functional systems design, or configuration and/or acceptance testing.

Responsibilities

• Accountable for functional system design, configuration, and review of high-level data flows and system requirements.
• Conduct various testing cycles (unit, UAT, end-to-end, regression) and ensure post-implementation QA and issue resolution.
• Develop and execute ad-hoc SQL queries, data migration plans, and back-up strategies; leverage Tableau and APIs for new tech.

Skills

SQL

Report Writing

AI Tools

Requirements Analysis

Communication

Team Collaboration

Leadership

Healthcare Domain

Education

College degree in CS/Math/Business

Tools

Tableau

APIs

SDLC

Job description

Provider Reimbursement Systems Analyst Hybrid role (3 days/week in office) at our Burlington, Renton, Spokane, Vancouver, Portland, Medford, Salt Lake City, Boise, Lewiston, Fargo offices. Candidates must reside within commutable distance of that location or be willing to relocate.

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

Who We Are Looking For:

Every day, Cambia’s dedicated team of Provider Reimbursement Systems Analysts are living our mission to make health care easier and lives better.

As a member of the Customer Experience and Operations team, our Provider Reimbursement Systems Analysts participates in the daily support, maintenance, and enhancement of existing systems, as well as the development, configuration, and delivery of new systems to directly support Cambia Core Strategies and Key Initiatives – all in service of economically sustainable health care system.

What if your technical expertise could help transform the way millions of people experience health care? Ready to move beyond maintaining systems — and start building ones that actually change lives? Then this role may be the perfect fit.

Qualifications:

College degree is desired in Computer Sciences, Mathematics, Business Administration, or related fields. College degree may be substituted by sufficient years of experience in the health care industry A minimum of five years' experience in defining and analyzing business requirements, process modeling, functional systems design, or configuration and/or acceptance testing is desired.

Skills and Attributes:

• Demonstrated ability to develop general and detailed functional requirements, create and perform system testing, facilitate system configuration decisions, and report progress in various formats for project management purposes.
• Proven analytical skills with demonstrated competency in using rigorous logic, methods, and analytical skills in diagnosing complex business requirements, process modeling, functional system design, and/or acceptance testing.
• Proven communication skills with an ability to be both clear and concise, including the ability to facilitate communication between technical and business staff to find the best solutions to meet business requirements within deadlines.
• Ability to work effectively in a team environment along with the self-motivation to work independently or with minimal supervision, including the ability to tolerate and manage ambiguity.
• Demonstrated ability to provide leadership in requirements analysis, functional design, quality assurance, and implementation activities regarding departmental applications and their associated business processes.
• Demonstrated ability to develop project plans and schedules to ensure all tasks are identified and completed, and assigns tasks and workflow as necessary for completion, including the ability to support and answer questions from Level I team members.
• Demonstrated ability to lead the development of business cases, business contingency plans, business metrics, and measurements to improve efficiency within business support services.
• Demonstrated competency in one or more business areas supported by this position (i.e., claims processing, membership processing, product configuration, enrollment, and eligibility, etc.).
• Must have advanced SQL knowledge, report-writing capabilities, and a basic understanding of the software development lifecycle from conception to delivery.
• Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired.

What You Will Do at Cambia:

Accountable for functional system design, configuration, and review and approval of high-level data flows, functional and technical specifications, system implementation staging, change control, design alternatives, and functional system requirements. Conduct unit testing, user acceptance testing, end-to-end testing, and regression testing of fixes, enhancements, and system upgrades, followed by post-implementation quality assurance, troubleshooting, and issue resolution, including monitoring and implementing continuous process and system improvements. Review, analyze, and resolve sustainment issues associated with systems and/or processes, and develop and implement prudent approach, data migration, and back-up plans for any given update. Write and execute ad-hoc reports and queries, develop scripts that move or update data to replicate online functionality, and demonstrate proficiency in SQL while making recommendations on process and technology changes to support business efficiencies, including support of new technologies such as Tableau and APIs. Act as a liaison between business areas and technology partners, communicating software and system changes to front-line colleagues, management, senior leadership, vendors, and other internal Cambia teams, while responding to inquiries regarding system functionality, modification, and status of issue resolution. Schedule, organize, and prioritize work to ensure timely completion of all assignments, performing in a project and staff leadership role, assisting with project or production support duties as directed, and backing up supervisory colleagues as required. Assist in the development of Business Analysts and Senior Business Analysts, including training and communication of system changes for end users and other impacted colleagues.

Pay ranges vary based on the candidate's work location.

• Oregon, Washington, Utah, and Idaho: The expected hiring range is $92,700 - $125,400, the full salary range is $87,000 - $142,000 and the bonus target is 15%.
• North Dakota: The expected hiring range is $90,906.65 - $121,991.35 and the full salary range is $80,716 - $133,182.

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.

• 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.

Learn more about our benefits.

Work-from-home Options

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. As part of our security requirements, new hires will need access to a personal mobile device to set up Multi-Factor Authentication (MFA) upon joining the company. MFA is an important layer of protection for accessing Cambia systems and is required for all employees.

Equal Opportunity & Background Check

We are an Equal Opportunity employer dedicated to 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.

Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy.

Everyone is a health care consumer deserving of a simpler, more personalized experience. Cambia is transforming the health care system to revolve around people. For over 100 years we’ve designed people-first health solutions rooted in the nation’s first health plan, a loggers’ wage pool established in the Pacific Northwest. Today that pioneering spirit aligns our family of over 20 companies, including 4 not-for-profit BlueCross and BlueShield licensed health plans serving over 3 million Americans. Cambia blends data science with a compassionate human perspective to anticipate people’s needs, and empower them to make smarter health care choices.