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 Provider Engagement Team is living our mission to make health care easier and lives better. As a member of the Network Management team, our Provider Performance Director develops and implements provider engagement strategies to drive performance improvements in population health, quality, and outcomes, analyzes data, sets targets, and identifies innovative solutions to support practice transformation and achieve business objectives - all in service of making our members' health journeys easier.
Do you have a passion for identifying provider performance opportunities and delivering actionable insights? Do you have excellent presentation skills and thrive as part of a collaborative, caring team? Then this role may be the perfect fit.
What You Bring to Cambia:
Qualifications:
The Provider Performance Director would have a Bachelor's Degree (Master's Degree preferred) in healthcare, science, business or related field and 12+ years' experience in one of the following areas: provider performance, quality improvement, population health management, provider contracting and reimbursement, managed care, healthcare delivery, risk adjustment, Stars, alternative payment models (APM) or equivalent combination of education and experience.
Skills and Attributes:
Demonstrated knowledge of medical group/IPA operations, integrated delivery systems, and health plans, as well as industry trends and challenges.
Understanding of provider coding, documentation practices, reimbursement, and contract methodologies.
Proven ability to identify problems, develop solutions, and implement actions to resolve issues and build consensus among diverse stakeholders.
Excellent communication and facilitation skills, with strong presentation and public speaking abilities.
Demonstrated analytical and problem-solving skills, with the ability to interpret and present complex data to various stakeholders.
Proficient in using collaboration tools, presentation software, CRM, reporting, and spreadsheet software to create and maintain databases, reports, and documents.
Ability to work independently, managing priorities, driving results, and effectively handling high-pressure environments and conflict.
What You Will Do at Cambia:
Initiates and leads network efforts focused on industry best practices, acquiring deep knowledge of cost, quality, and utilization metrics to oversee performance.
Contributes to the development and execution of cohesive network business strategies, partnering with Network Management leadership and subject matter experts.
Improves provider organization performance through data analysis, knowledge of best practices, and development of interventions in collaboration with peers and leaders.
Serves as a subject matter expert on APMs, staying informed and updated on value-based care contracts, program changes, and industry trends.
Develops and deploys best-practice network incentives/recognition, participating in internal workgroups to support development of effective member and provider network-directed interventions.
Leverages Quality Incentive Program to promote provider-focused use of available resources and tools to improve member health outcomes.
Maintains professional and technical knowledge by attending educational workshops, reviewing professional publications, and participating in professional societies.
Develops strategies to increase provider engagement on APM objectives, articulating the value proposition and mutual benefits to improve member health outcomes and APM performance.
Sets and tracks provider engagement key performance indicators (KPIs) assesses and communicates project status, key business risks, and vulnerabilities to leadership, recommending and implementing action steps as needed.
Adheres to all quality, compliance, and regulatory standards.
The expected hiring range for a Provider Performance Director is $132,600 - $179,400 depending on skills, experience, education, and training; relevant licensure /certifications; and performance history. The bonus target for this position is 20%. The current full salary range for this role is $124,000 - $203,000.
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 (eligible day one of employment if within first 12 months following birth or adoption).
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.
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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.
