Risk Management Team Lead, Data & Compliance

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

Benefits offered by this job

Health benefits

401(k) match

Parental leave

Wellness programs

Job summary

Cambia Health is seeking a Manager of the Risk Management Business Team to lead data submission for enrollment, medical and pharmacy claims within CMS Risk Adjustment programs, with a hybrid in-office schedule. You will guide a team through data extraction, validation, and translation to the Edge Server, driving accuracy and regulatory compliance.

The role requires a Bachelor’s degree and 10+ years in data analysis or process modeling, plus strong leadership and project management skills.

Qualifications

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

Responsibilities

• Oversee data submission measurements and RADV audits with cross‑functional teams.
• Develop medical underwriting rules reflecting rating strategy and revenue targets.
• Direct projects and define performance criteria and objectives for the Risk Management team.
• Ensure day‑to‑day operations are supported by the Risk Management team and resolve issues.
• Develop and maintain departmental policies, processes and procedures.
• Create training materials and deliver staff development; mentor team members.
• Coordinate with IT and other departments to ensure data submission system accuracy.

Skills

Analytical skills

Project management

Leadership

Communication

Data analysis

Business knowledge

Education

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

Job description

Cambia Health is seeking a Manager of the Risk Management Business Team to lead data submission for enrollment, medical and pharmacy claims within CMS Risk Adjustment programs, with a hybrid in-office schedule. You will guide a team through data extraction, validation, and translation to the Edge Server, driving accuracy and regulatory compliance.

The role requires a Bachelor’s degree and 10+ years in data analysis or process modeling, plus strong leadership and project management skills.