Risk Adjustment Provider Educator

Cambia-posted 4 days ago

Full-time • Mid Level

Hybrid

5,001-10,000 employees

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Every day, Cambia's dedicated team of Provider Educators is living our mission to make health care easier and lives better. As a member of the Risk Adjustment team, our Provider Educators are responsible for developing communications, content and engaging network providers in support of provider education objectives. - all in service of creating a person-focused health care experience . Do you have a passion for serving others and learning new things? Do you thrive as part of a collaborative, caring team? Then this role may be the perfect fit.

Develops, coordinates, and drives risk adjustment education initiatives with network providers and acts as primary point of contact for assigned key provider engagements across Commercial and Medicare lines of business
Coordinate outreach, communication, training, and education for providers that have been identified through various operational reporting channels as a candidate for provider education engagement
Works with key leaders within the provider organization to engage with and drive successful performance of the provider engagement.
Assists senior leadership with special projects related to advancing Cambia's value based and innovative provider relationships.
Participates in definition of project deliverables, providing consultation, recommendations, and solutions, reviewing project mandates and directives to determine overall provider engagement approach
Leads, under the direction of management, in design and implementation of initiative related administrative policies and procedures and provides guidance and direction to the work team

Provider Education Coordinator would have a Bachelor's degree in a related field and at least 5 years of Medicare Advantage or Commercial risk adjustment experience including at least 4 years of experience in a HCC Coding Audit or Network Management role or equivalent combination of education and experience.
Strong consulting, communication (written and verbal), influencing, and facilitation skills
Proficiency in using Microsoft Office tools and proven ability to display analytical data and research findings for effective presentations and improved decision making.
Knowledge of health care industry trends, provider relations, and risk adjustment HCC coding, ICD10 diagnosis coding.
Knowledge of health insurance preferred, including medical and dental terminology, procedural and diagnosis coding, reimbursement methodologies and various provider network arrangements.

CPC and/or CRC credentials preferred

Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits.
Annual employer contribution to a health savings account.
Generous paid time off varying by role and tenure in addition to 10 company-paid holidays.
Market-leading retirement plan including a company match on employee 401(k) contributions, with a potential discretionary contribution based on company performance (no vesting period).
Up to 12 weeks of paid parental time off (eligibility requires 12 months of continuous service with Cambia immediately preceding leave).
Award-winning wellness programs that reward you for participation.
Employee Assistance Fund for those in need.
Commute and parking benefits.

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