Job description
Risk Adjustment Provider Educator
Work Remotely From Oregon, Washington, Idaho or Utah
Primary Job Purpose
The Provider Education Coordinator is responsible for developing communications, content and engaging network providers in support of provider education objectives. This role will collaborate with functional areas of the organization to create and curate engaging, provider audience-driven content and deliver strategic communications for target external and internal audiences. The position works closely with various stakeholders, including: Network Management, Risk Adjustment, project managers, and technical support in creating and maintaining communication delivery channels, and support project and event deliverables as needed to help achieve organizational goals related to improving the accuracy of diagnosis submissions for risk adjustment purposes.
General Functions and Outcomes
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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
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Coordinate outreach, communication, training, and education for providers that have been identified through various operational reporting channels as a candidate for provider education engagement
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Works with key leaders within the provider organization to engage with and drive successful performance of the provider engagement.
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Assists senior leadership with special projects related to advancing Cambia’s value based and innovative provider relationships.
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Participates in definition of project deliverables, providing consultation, recommendations, and solutions, reviewing project mandates and directives to determine overall provider engagement approach
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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
Minimum Requirements
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Strong consulting, communication (written and verbal), influencing, and facilitation skills
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Proficiency in using Microsoft Office tools and proven ability to display analytical data and research findings for effective presentations and improved decision making.
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Knowledge of health care industry trends, provider relations, and risk adjustment HCC coding, ICD10 diagnosis coding.
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Knowledge of health insurance preferred, including medical and dental terminology, procedural and diagnosis coding, reimbursement methodologies and various provider network arrangements.
Normally to be proficient in the competencies listed above
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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.
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CPC and/or CRC credentials encouraged
Work Environment
- No unusual working conditions.
- Work primarily performed in an office environment.
- Some travel may be required
The base pay annual salary range for this job is $76,000.00 to $123,500.00
At Cambia, we take a variety of factors into account when creating a job offer, including your skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. While we offer competitive salaries, in general, we rarely hire candidates at or near the top of the salary range.
Base pay is just part of the compensation package at Cambia that is supplemented with an exceptional 401(k) match, bonus opportunity and other benefits. In keeping with our Cause and vision, we offer comprehensive well-being programs and benefits, which we periodically update to stay current. Some highlights:
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medical, dental, and vision coverage for employees and their eligible family members
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annual employer contribution to a health savings account ($1,200 or $2,500 depending on medical coverage, prorated based on hire date)
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paid time off and company holidays
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up to a 6% company match on employee 401k contributions, with a potential discretionary contribution based on company performance (no vesting period)
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up to 12 weeks of paid parental time off (eligible day one of employment if within first 12 months following birth or adoption)
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one-time furniture and equipment allowance for employees working from home
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up to $225 in Amazon gift cards for participating in various well-being activities for a complete list see ourExternal Total Rewardspage.
We are an Equal Opportunity and Affirmative Action employer dedicated to workforce diversity and a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required.
If you need accommodation for any part of the application process because of a medical condition or disability, please email
CambiaCareers@cambiahealth.com
. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our
Privacy Policy
. As a health care company, we are committed to the health of our communities and employees during the COVID-19 pandemic. Please review the policy on our
Careers
site.
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