Risk Adjustment Provider Educator

Cambia Health Solutions • Salt Lake, UT

3d • Hybrid

About The Position

Provider Educator Work a Hybrid schedule within Oregon, Washington, Idaho or Utah Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system. Who We Are Looking For: 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.

Requirements

• 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.

Nice To Haves

• CPC and/or CRC credentials preferred

Responsibilities

• 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

Benefits

• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees