Risk Adjustment Provider Educator

Cambia Health Solutions; Salt Lake City (UT); Remote; USD 77,000 - 127,000; Full time

Job summary

Cambia Health Solutions seeks a Risk Adjustment Provider Educator to enhance provider education efforts within its dedicated Risk Adjustment Operations team. This role involves developing communication strategies, engaging network providers, and overseeing risk adjustment initiatives. Candidates must possess significant experience in risk adjustment, including required certifications, and display strong communication and analytical skills. Join Cambia to contribute to creating a sustainable health care system focused on person-centered care.

Benefits

401(k) with company match

Health coverage

Paid time off

Parental leave

Wellness programs

Qualifications

• Minimum 5 years of Medicare Advantage or Commercial risk adjustment experience.
• Minimum 4 years of experience in HCC Coding Audit or Network Management role.
• CRC credentials are required.

Responsibilities

• Develop and coordinate risk adjustment education initiatives.
• Engage with key leaders within provider organizations.
• Assist senior leadership with projects related to value-based provider relationships.

Skills

Risk Adjustment Experience

Risk Coding

Strong consulting skills

Communication skills

Knowledge of healthcare industry trends

Education

Bachelor’s degree in a related field

Tools

Microsoft Office

Job description

Risk Adjustment Provider Educator

Work from home within Oregon, Washington, Idaho, or Utah (WA PREFERRED)

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

Who We Are Looking For :

Every day, Cambia’s dedicated Risk Adjustment Operations team lives our mission to make health care easier and lives better. As our Risk Adjustment Provider Educator, you will develop communications, content, and engage network providers to support provider education objectives, all in service of making our members’ health journeys easier.

Preferred Key Experience :

• Risk Adjustment Experience (MUST HAVE)
• Risk Coding - CRC Certification (MUST HAVE)
• Network Contracts experience
• Value Based Arrangements
• Medical Advantage Knowledge

What You Bring to Cambia :

Qualifications :

Bachelor’s degree in a related field

Minimum 5 years of Medicare Advantage or Commercial risk adjustment experience, including

Minimum 4 years of experience in an HCC Coding Audit or Network Management role

Equivalent combination of education and experience.

CRC credentials are required.

Skills and Attributes :

• Strong consulting, communication (written and verbal), influencing, and facilitation skills
• Proficiency in Microsoft Office tools and ability to present analytical data and research findings effectively
• Knowledge of healthcare industry trends, provider relations, and risk adjustment HCC coding, ICD10 diagnosis coding
• Knowledge of health insurance, including medical and dental terminology, procedural and diagnosis coding, reimbursement methodologies, and provider network arrangements

What You Will Do at Cambia :

• Develop and coordinate risk adjustment education initiatives with network providers
• Coordinate outreach, communication, training, and education for providers identified through operational reporting channels
• Engage with key leaders within provider organizations to drive performance
• Assist senior leadership with projects related to value-based and innovative provider relationships
• Define project deliverables, provide recommendations, and review project mandates
• Lead the design and implementation of administrative policies and procedures related to initiatives

The expected hiring range is $90,000-$100,000 annually, depending on skills, experience, education, certifications, and performance. The bonus target is 10%. The full salary range is $77,000 (Low) to $127,000 (High).

About Cambia

Working at Cambia means being part of a purpose-driven, award-winning culture built on trust and innovation. Our team is committed to sustainable, person-focused health care, and we prioritize compassion, empathy, and teamwork.

Why Join Cambia?

• Collaborate with diverse teams to transform health care
• Earn a competitive salary and benefits
• Grow your career with us
• Participate in outreach programs
• Connect with colleagues through resource groups

Our compensation includes a competitive base pay, a 401(k) with a company match, bonuses, and more. Benefits include health coverage, HSA contributions, paid time off, parental leave, wellness programs, and other perks.

Work From Home Options

We offer flexible work from home options, requiring a wired internet connection with minimum speeds of 5Mb upload and 10Mb download.

Equal Opportunity Employer

We are committed to diversity and a drug-free workplace. All qualified applicants will receive consideration without regard to protected statuses. Background checks are required.

If you need accommodations during the application process, please contact us via email. More information about our data practices is available in our privacy policy.