Risk Adjustment Provider Educator

Join to apply for the Risk Adjustment Provider Educator role at Cambia Health Solutions

Provider Educator working a hybrid schedule within Oregon, Washington, Idaho or Utah. Build a career with purpose by joining our cause to create a person‑focused and economically sustainable health care system.

• Develop, coordinate, and drive risk adjustment education initiatives with network providers and act 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 identified through various operational reporting channels as candidates for provider education engagement.
• Work with key leaders within the provider organization to engage with and drive successful performance of the provider engagement.
• Assist senior leadership with special projects related to advancing Cambia’s value‑based and innovative provider relationships.
• Participate in the definition of project deliverables, providing consultation, recommendations, and solutions, reviewing project mandates and directives to determine overall provider engagement approach.
• Lead, under the direction of management, the design and implementation of initiative‑related administrative policies and procedures and provide guidance and direction to the work team.

• 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 in an HCC coding audit or network management role (or an equivalent combination of education and experience).
• CPC and/or CRC credentials preferred.

• 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, ICD‑10 diagnosis coding.
• Knowledge of health insurance preferred, including medical and dental terminology, procedural and diagnosis coding, reimbursement methodologies and various provider network arrangements.

• No unusual working conditions.
• Work performed primarily in an office environment.
• Some travel may be required.

The expected hiring range for a Provider Educator is $83,300.00 - $ depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. The bonus target for this position is 10%. The full salary range for this role is $78,000.00 to $.

• 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.

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 5 Mb and a minimum download speed of 10 Mb.

We are an Equal Opportunity employer dedicated to 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 C Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy.