Risk Adjustment Operations Manager (Hybrid)

Cambia Health; Renton (WA); Hybrid; USD 111,000 - 151,000; Full time

Benefits offered by this job

Medical, dental and vision coverage

Generous PTO

Company 401(k) match

Bonus opportunities

Job summary

Cambia Health is seeking a Manager, Risk Management for the Risk Adjustment Business Team in a hybrid role. The position oversees data submission and audits, develops underwriting rules, and collaborates with IT, compliance, and other departments to ensure accuracy and timely reporting.

Location flexibility includes in-office days and remote work, with focus on driving accurate risk adjustment processes, staff development, and cross-functional leadership across multiple offices.

Qualifications

• Bachelor's degree in Business, Data Analysis or related field.
• 10+ years in data analysis, process modeling or equivalent.
• Experience leading large, complex initiatives.

Responsibilities

• Corroborates with IT, compliance, legal, revenue management and other departments to maximize submission measurements.
• Oversees RADV audits, submits data timely and prepares executive reports.
• Develops medical underwriting rules for the Risk Management system reflecting rating strategy.

Skills

Analytical skills

Data analysis

Project management

Leadership

Communication skills

Education

Bachelor's degree in Business, Data Analysis or related field

Tools

Edge Server

AI tools

Data systems

Job description

Cambia Health is seeking a Manager, Risk Management for the Risk Adjustment Business Team in a hybrid role. The position oversees data submission and audits, develops underwriting rules, and collaborates with IT, compliance, and other departments to ensure accuracy and timely reporting.

Location flexibility includes in-office days and remote work, with focus on driving accurate risk adjustment processes, staff development, and cross-functional leadership across multiple offices.