Quality Improvement Coordinator

Cambia Health Solutions•Salt Lake, UT

4d•Hybrid

About The Position

The Quality Improvement Coordinator turns Quality Assurance and external audit findings 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 is a hybrid position requiring three days per week in an office. Locations include Salt Lake City, Utah; Boise and Lewiston, Idaho; Fargo, North Dakota; Portland and Medford, Oregon; Vancouver, Renton, and Burlington, Washington; and Little Rock and Springdale, Arkansas. Preference is given to current employees and candidates who live within commuting distance of specified offices or are willing to relocate. The coordinator analyzes audit and quality results, identifies defects and root causes, and leads improvement projects in partnership with Quality Assurance and Member Services. The role also monitors quality measures, assesses the impact of processing errors, recommends corrective actions, and coordinates system enhancements, testing, implementation, reporting, documentation, and training. The position builds relationships across Member Services, Quality Assurance, Reporting, and Internal Audit. The expected hiring range depends on location and qualifications. For the national pay structure, the expected hiring range is $69,500–$95,500, with a full range of $66,000–$108,000 and an 8% bonus target. For the regional pay structure, the expected hiring range is $66,850–$86,350, with a full range of $59,000–$98,000 and an 8% bonus target. Cambia describes its culture as purpose-driven and focused on trust, innovation, and sustainable, person-focused health care. The company offers flexible work-from-home options for most roles, subject to wired internet requirements, and requires new hires to use a personal mobile device to set up multi-factor authentication. A background check is required.

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.
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.
Ability to manage multiple projects and priorities, take initiative, meet deadlines, and build effective cross-functional working relationships.
Strong interpersonal and presentation skills, including communicating with staff at all levels and with large and small groups.

Nice To Haves

Claims, Membership, Customer Service, or Multi-Service experience applicable to the position is preferred.
Completion of formal quality training or familiarity with quality principles.
Experience with AI tools and technologies to enhance productivity and decision-making in professional settings.
Creative problem-solving and business or operational process-improvement experience.
Facilitation skills.

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 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, coordinating testing, implementation, reporting, documentation, and training activities.
Build working relationships across Member Services, Quality Assurance, Reporting, and Internal Audit.
Participate in calibration meetings and quality summits as needed.

Benefits

Competitive base pay and bonus opportunities, with an 8% bonus target.
Market-leading 401(k) with a company match and potential discretionary contribution based on company performance.
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.
Up to 12 weeks of paid parental time off, subject to eligibility requirements.
Award-winning wellness programs that reward participation.
Employee Assistance Fund.
Commute and parking benefits.
Flexible work-from-home options for most roles.
Employee resource groups.
Cambia-supported community outreach opportunities.