Risk Management BSA I, II, III

Cambia Health • Beaverton, OR

31d • Hybrid

About The Position

Every day, Cambia's dedicated team of Business System Analysts (BSA) is living our mission to make health care easier and lives better. As a member of the Risk Management team, our BSAs are responsible for complying with CMS mandates to submit Enrollment, Medical Claim and Pharmacy Claims data for Reinsurance Reimbursement, Member Risk Assessment and Risk Corridor calculations - all in service of making our members' health journeys easier. 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

• Bachelor's degree in Business, Data Analysis or other related field plus 2 years' experience with data analysis, process modeling or equivalent combination of education and experience.
• Experience aggregating, reviewing and extracting data from various sources to create larger, more complex data sets.
• Good research and problem solving skills including the ability to determine action steps and remediation actions to resolve issues.
• Ability to accurately complete activities within established deadlines. Ability to work under pressure and partner with others.
• Good written and verbal communication skills including the ability to work with internal and external partners.
• Proficiency with Microsoft Office software programs and general experience database query tools.
• Ability to update process documentation to ensure activities and outputs align with CMS guidelines.
• General knowledge of medical terminology and procedure coding.

Nice To Haves

• Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired.

Responsibilities

• Extracts required information from the source systems into a staging area and performs validation checks based on CMS Edge Server Business Rules.
• Submits data to the Edge Server via an established translation process.
• Reviews data validation reports that are received back from CMS and any errors are investigated and corrected prior to data being resubmitted.
• Communicates with internal/external customers to resolve any errors within the source systems for any of the above areas.
• Encourages ongoing innovation and looks for opportunities to enhance the quality and efficiency of departmental processes.
• Assists in the training and communicating system changes for end-users and other affected staff.
• Schedules, organizes and prioritizes work to ensure timely completion of all assigned activities.
• Maintins process documentation and ensures data submission and validation activities align with CMS guidelines.

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: Entry Level
• Industry: Ambulatory Health Care Services
• Number of Employees: 5,001-10,000 employees