Risk Management & Data Compliance Manager

Cambia Health; Bismarck (ND); Híbrido; USD 101.000 - 167.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Work from home options

Competitive benefits

401(k) with company match

Paid time off & holidays

Descripción de la vacante

Cambia Health is seeking a Manager, Risk Management Business Team to lead a cross-functional group responsible for data submission for risk adjustment and reinsurance programs. The role collaborates with IT, compliance, revenue management and product teams to ensure accurate data flow and audits.

The position requires a strong analytics background, experience leading large initiatives, and proficiency in risk adjustment systems.

Formación

• Bachelor's degree in Business, Data Analysis or related field.
• 10+ years' experience with data analysis, process modeling or equivalent combination of education and experience.

Responsabilidades

• Corroborates with IT, compliance, legal, revenue management, claims, enrollment, product teams to maximize submission measurements.
• Oversees RADV audits and prepares executive reports.
• Develops underwriting rules reflecting rating strategy to drive revenue targets.
• Directs projects and defines performance criteria and objectives.
• Ensures day-to-day operations are supported by the Risk Management team.

Conocimientos

Analytical skills

Communication

Risk adjustment knowledge

Project management

Medical terminology

Team leadership

Data systems

AI tools experience

Educación

Bachelor's degree in Business or related field

Herramientas

Edge Server

AI tools

Descripción del empleo

Cambia Health is seeking a Manager, Risk Management Business Team to lead a cross-functional group responsible for data submission for risk adjustment and reinsurance programs. The role collaborates with IT, compliance, revenue management and product teams to ensure accurate data flow and audits.

The position requires a strong analytics background, experience leading large initiatives, and proficiency in risk adjustment systems.