Assistant Director of Risk Adjustment Analytics 

Work from home 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 Risk Adjustment professionals is living our mission to make health care easier and lives better. As a member of the Government Programs team, our Assistant Director of Risk Adjustment Analytics’ goal is to identify business needs, recommend new and/or improved processes, solicits stakeholder and end user requirements, and create and maintain all related documentation – all in service of creating a person-focused health care experience.  

As a people leader, you are willing to learn and grow, understanding that leadership is a craft that is continuously honed as you support your team and the lives that depend upon us.

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. 

What You Bring to Cambia: 

Qualifications:  

Assistant Director, Government Programs Analytics would have a Bachelor's Degree (Masters preferred) in Business Analytics, Statistics, Information Management, Mathematics, Business Administration or related field, 5+ years of experience in Medicare and ACA Risk Adjustment, 7 years of experience in business analysis, and at least 5 years management/leadership experience or an equivalent combination of education and experience.

Skills and Attributes: 

Strong people leader focused on developing a high-performing team and ensuring the team has the resources and tools needed to be successful.

Deep expertise in Risk Adjustment for Medicare and Commercial (ACA) members.

Expert level analytical skills, with the ability to analyze complex data and situations, learn quickly and synthesize corresponding solutions, options and action plans.

Expert knowledge related to Risk Adjustment systems and processes.

Ability to communicate complex issues in a crisp, concise way to audiences at all levels.

Demonstrated experience in designing and implementing core people, process and technology improvement solutions. Working knowledge of LEAN process improvement principles.

Demonstrated experience with structured analysis and design methodologies and processes as executed on large application development/enhancement projects.

Demonstrated experience in business areas, working with business requirements, requirements documentation, or business modeling plus familiarity with systems and data analysis. 

Demonstrated experience managing the development and implementation of business analysis processes including: requirements gathering, documentation, client relationship development, enterprise business models, especially in insurance, health care and financial services, in a complex organizational setting.

What You Will Do at Cambia:  

Attract, develop and retain the best talent for Cambia; provide effective leadership and oversight to get the best long-term performance from the team and assist in making Cambia the employer of choice in our markets.

Lead analytical support efforts to any or all divisions of the organization by mining data, conducting analysis, and interpreting results related to business needs.

Lead efforts to develop methodologies and approaches to new tasks and projects through design and development of analytical models and reports.

Lead or co-lead projects to install new systems or improve current systems, working with both internal and external Government Programs, network, clinical, finance, actuarial, quality, provider relations, Chief Data Office (CDO) and IT staff. Implement business system plans and set development priorities.

Consult with Shared Services to introduce Government Programs systems that interact with other business process information systems effectively addressing complex issues and system interactions with strategic impact on both Medicare and commercial product lines and associated processes.

Assure adherence to departmental policies and procedures.

Collaborate in the purchase and integration of Government Programs products and services from third-party vendors, consultants, and contractors.

Consult with IT and CDO architects to formulate Government Programs business architecture, assessing cost and feasibility of system requests and ensuring the plan supports both strategic and near-term business needs.

Integrate activities with other business units, CDO and IT to ensure the successful implementation and support for Government Programs projects and initiatives.

Serve as budget liaison for Government Programs when developing the annual department budget as well as budget for new Government Programs initiatives.

Work with Government Programs executive leadership to design, plan, and align the interests and goals of the department with other parts of the business.

Handle all management level responsibilities for staff, including performance reviews, employee development, hiring, coaching, counseling, and retention.  Regularly communicate organizational objectives and team goals. 

Assist with financial targets and department budget, authorize expenditures, monitor workforce allocation and resources, and oversee project plans.

As a member of our strong leadership community, you will provide direction to your team, engage them towards common goals and create a positive experience that helps people flourish. 

The expected hiring range for a AD Risk Adjustment Analytics is $132,600.00 - $179,400.00 depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. The bonus target for this position is 15%.  The current full salary range for this role is $124,000.00 to $203,000.00.                                                                 

#LI-remote

FTEs Supervised

5-6 direct reports, 4-8 indirect reports.

Work Environment

Work is primarily performed in an office environment

Travel may be required, either locally or out of state

About Cambia

Working at Cambia means being part of a purpose-driven, award-winning culture built on trust and innovation anchored in our 100+ year history. Our caring and supportive colleagues are some of the best and brightest in the industry, innovating together toward sustainable, person-focused health care.  Whether we're helping members, lending a hand to a colleague or volunteering in our communities, our compassion, empathy and team spirit always shine through.

Why Join the Cambia Team?

At Cambia, you can:  

Work alongside diverse teams building cutting-edge solutions to transform health care.  Earn a competitive salary and enjoy generous benefits while doing work that changes lives.  Grow your career with a company committed to helping you succeed. Give back to your community by participating in Cambia-supported outreach programs.  Connect with colleagues who share similar interests and backgrounds through our employee resource groups.  

We believe a career at Cambia is more than just a paycheck – and your compensation should be too. Our compensation package includes competitive base pay as well as a market-leading 401(k) with a significant company match, bonus opportunities and more.  

In exchange for helping members live healthy lives, we offer benefits that empower you to do the same. Just a few highlights include: 

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. 

Learn more about our benefits. 

We are happy to offer work from home options for most of our roles. To take advantage of this flexible option, we require employees to have a wired internet connection that is not satellite or cellular and internet service with a minimum upload speed of 5Mb and a minimum download speed of 10 Mb.

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.