Program Manager or Sr DOE - Provider Incentives

Program Manager or Sr DOE - Provider Incentives

Hybrid in Idaho, Oregon, Washington, Utah

Build a career with purpose. Join our to create a person-focused and economically sustainable health care system.

Who We Are Looking For :

Every day, Cambia’s dedicated team of Program Managers are living our mission to make health care easier and lives better. As a member of the Risk Adjustment and Stars team, our Program Managers partner with cross functional teams to develop, drive, and lead strategic initiatives to successfully meet Government Programs goals and objectives. Responsible for building trusting relationships between all stakeholders in provider incentive programs and Government Programs teams by understanding each team's vision, strategy and business objectives and establishing credibility as a trusted expert resource to influence positive outcomes – all in service of making our members’ health journeys easier.

Are you passionate about driving meaningful change in healthcare through strategic collaboration? Are you energized by the challenge of aligning multiple stakeholders toward common goals? Then this role may be the perfect fit.

What You Bring to Cambia :

Qualifications :

Bachelor’s degree (Master's preferred) in Nursing, Public Health, Healthcare or Business Administration or related field

Minimum 5 years relevant experience in a population health in a large healthcare delivery, health insurance or health care consulting organization with specific Medicare / Government Programs or clinical / population health experience including demonstrated experience leading a program or equivalent combination of education.

Skills and Attributes :

Demonstrates extensive experience with Medicare, Quality, Stars and Risk Adjustment activities, including the ability to educate internal teams and providers on the importance of these activities to the success of Regence and provider organizations

Possesses strong experience in evaluating and managing multiple complex programs to ensure they achieve business objectives, with advanced knowledge of health insurance industry trends, Commercial and Federal Employee Program (FEP) legislation, regulations and exposure to integrated finance and delivery models as they relate to population health management and improving member health outcomes

Serves as the Government Programs subject matter expert and primary point of contact for all Quality Incentive Programs (QIP) stakeholders and for providers with more complex QIP and provider incentives issues and questions

Collaborates with teams that support Network Management with Medicare-specific data and education, while maintaining responsibility for Provider Incentive Program development, related metrics, and program operations

Acts as the liaison between QIP / provider incentives and Network Management to ensure transparency, effective communication and alignment, while maintaining general knowledge of value-based arrangements, including contract terms and performance targets

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

Exhibits advanced communication and facilitation skills with all levels both within and outside the organization, including the ability to identify problems, develop solutions, and implement chosen courses of action to resolve complex issues and build consensus while leading and motivating others through ambiguity in fast-paced environments

Demonstrates experience coordinating initiatives and bringing people together across multiple locations and functions while working across a highly matrixed organization, with advanced problem-solving skills and the ability to think about population health, clinical and business problems in new ways

Supports internal and external partners in developing strong working relationships with strategic providers to develop and / or support incentive / performance strategies that produce improved outcomes for members and enhance the member experience while providing mutual strategic benefit for the provider and Regence

What You Will Do at Cambia :

Extensive experience with Medicare, Quality, Stars and Risk Adjustment activities, including the ability to educate internal teams and providers on the importance of these activities to the success of Regence and provider organizations

Strong experience in evaluating and managing multiple complex programs to ensure they achieve business objectives and deliver measurable outcomes

Advanced knowledge of health insurance industry trends, Commercial, FEP, and Medicare legislation, regulations, and exposure to integrated finance and delivery models as they relate to population health management and improving member health outcomes

Advanced communication and facilitation skills with all levels both within and outside the organization, including the ability to identify problems, develop solutions, and implement chosen courses of action to resolve complex issues and build consensus

Experience leading and motivating others by influencing and leading through ambiguity, with the ability to thrive in extremely fast-paced environments

Proven ability to coordinate initiatives and bring people together across multiple locations and functions while working effectively across highly matrixed organizations

Strong problem-solving skills with demonstrated ability to think about population health, clinical, and business problems in innovative ways and clarify key issues in complex situations

Expertise in developing and implementing strategic solutions that drive organizational success while managing competing priorities and stakeholder interests

#LI-Hybrid

The expected hiring range for a Program Manageris $100,300 - $135,700depending on skills, experience, education, and training; relevant licensure / certifications; and performance history. The bonus target for this position is 15%. The current full salary range for this role is $94,000 - $154,000.

The expected hiring range for a Program Manager Sris $110,500 - $149,500depending on skills, experience, education, and training; relevant licensure / certifications; and performance history. The bonus target for this position is 15%. The current full salary range for this role is $104,000 - $169,000.

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 :

Learn more about our .

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 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 . Information about how Cambia Health Solutions collects, uses, and discloses information is available in our .