Quality Improvement Coordinator

Cambia Health Solutions • Medford, OR

5d • $59,000 - $108,000 • Hybrid

About The Position

The Quality Improvement Coordinator analyzes Quality Assurance and external audit findings and turns them into measurable improvement initiatives across Claims, Membership, and Customer Service. The role partners with staff and leaders to strengthen processes, improve quality results, and support better member and provider experiences. It coordinates quality projects, monitors measures, identifies root causes, and recommends practical corrective actions. The position is hybrid, with three days per week in the office, at listed Cambia offices in Utah, Idaho, North Dakota, Oregon, Washington, and Arkansas. Preference is given to current employees and candidates who live within commuting distance of specified offices or are willing to relocate.

Requirements

• Bachelor's degree in business, health care, communications, or a related field, or equivalent work experience related to membership, customer service, claims processing, and the health care insurance industry.
• At least five years of experience in Claims, Membership, and/or Customer Service relevant to audit responsibilities, or an equivalent combination of education and experience.
• At least three years of related Quality Assurance, Quality Improvement, or Quality Management experience.
• Thorough knowledge of applicable systems, reference manuals, and operational resources, with a record of meeting established departmental performance standards.
• Ability to understand and apply statistical and mathematical concepts, including sampling methodology, trending, and root cause analysis; formal quality training or familiarity with quality principles.
• Expert PC skills and proficiency with corporate software such as Microsoft Word, Excel, and Outlook.
• Experience with data access tools such as SQL and Microsoft Access.
• Strong interpersonal and presentation skills, including the ability to communicate with staff at all levels and with large and small groups.
• Ability to manage multiple projects and priorities, take initiative, meet deadlines, and build effective cross-functional working relationships.

Nice To Haves

• Claims, Membership, Customer Service, or Multi-Service experience applicable to the position is preferred.
• Experience with AI tools and technologies to enhance productivity and decision-making in professional settings is highly desired.
• Creative problem-solving and business or operational process-improvement experience is desired.
• Facilitation skills are preferred.

Responsibilities

• Analyze Quality Assurance and external audit results to identify defects, trends, root causes, and measurable opportunities for improvement.
• Develop, implement, and maintain quality improvement initiatives, plans, presentations, reports, and long-term goals in partnership with staff and management.
• Manage and facilitate quality improvement projects that strengthen Member Services processes, improve member and provider satisfaction, and increase business productivity.
• Monitor quality measures, prioritize projects that maximize return on investment, and report progress and accomplishments to Quality Assurance and Member Services management.
• Assess the scope and potential frequency or financial impact of processing errors and recommend feasible corrective actions.
• Initiate and track system enhancements and upgrades that support quality, including coordination, testing, implementation, reporting, documentation, and training activities.
• Build strong working relationships across Member Services, Quality Assurance, Reporting, and Internal Audit.
• Participate in calibration meetings and quality summits as needed.

Benefits

• Medical, dental, and vision coverage for employees and eligible family members, including mental health benefits.
• Annual employer contribution to a health savings account.
• Paid time off varying by role and tenure, in addition to 10 company-paid holidays.
• Retirement plan with a company match on employee 401(k) contributions and a potential discretionary contribution based on company performance, with no vesting period.
• Up to 12 weeks of paid parental time off, subject to eligibility requirements.
• Wellness programs that reward participation.
• Employee Assistance Fund.
• Commute and parking benefits.
• Competitive base pay and bonus opportunities.
• Work-from-home options for most roles, subject to wired internet requirements.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level