Manager Risk Adjustment
Cambia Health

Manager Risk Adjustment

Work Remotely from Oregon, Washington, Idaho or Utah

Primary Job Purpose

The Manager Risk Adjustment Campaign Execution leads a team that manages multiple small to large-scale complex projects related to Medicare and Commercial risk adjustment campaigns. Oversees all aspects of the projects or programs such as change in direction, scope, costs and timing while minimizing financial risks. Oversees the project activities of multiple project managers or functional leaders and works closely with leadership to ensure successful delivery of the projects and program.

General Functions and Outcomes

• Oversees and is accountable for the successful campaign delivery and outcomes of the team, achieved through effective project planning, task definition, scope management, capacity planning, resource allocation and negotiation, risk mitigation, cost management, and stakeholder communication. Accountable for the quality and timeliness of all defined campaigns, and for issue resolution within the projects.
  
• Ensures integration of related campaigns and adjusts scope, timing, and budgets as needed, based on the needs of the business.
  
• Reports out key project milestones to stakeholders and department leadership and recommends any necessary adjustments.
  
• Provides team leadership and creativity in the planning and implementation of the project, assigns individual responsibilities, identifies appropriate project resources and provides guidance and direction to project team members.
  
• Manages overall campaign plans, prepares and presents project plans and status reports to organizational leadership, project teams and client/customer groups.
  
• Provides overall guidance/responsibility for campaign/project plans, meeting coordination, communications, capacity and resource planning.
  
• Identifies, mitigates, and manages service provider operational risks and issues.
  
• Acts as the primary point of contact for service provider delivery leads. Accountable for managing and tracking performance outcomes and deliverables and vendor SLAs. Manages the service providers operations support functions, including Audits, Workflow, Delivery and Oversight Change Control and Escalations, Reporting, Training and Knowledge Management. Oversees the performance and delivery of service providers performing end-to-end operational processes. Leads activities, relationships and issue resolution with third-party service providers including productivity challenges.
  
• Responsible for campaign budget/financial targets, monitors internal and vendor workforce allocation and resources, and oversees project plans to ensure campaign aligns with pre-defined goals and objectives.
  
• Continuously drives to ensure and improve program quality, budget adherence, and successful outcomes.
  
• Interfaces with operations leadership to manage corporate goals, targets and initiatives.
  
• In conjunction with internal operational leaders and/or vendor management, develops monitoring and control procedures.
  
• Regularly communicates organizational objectives and team goals. Monitors results and metrics to ensure deliverables are met according to department standards. Collaborates with other leaders and across departments to resolve issues.
  
• Handles all management level responsibilities for staff, including performance reviews, employee development, hiring, firing, coaching, counseling, and retention. Develops supervisors and participates in talent management activities.
  

Minimum Requirements

• Knowledge of Medicare Advantage and/or Affordable Care Act rules and regulations, preferably with experience related to Risk Adjustment policies and best practices.
  
• Demonstrated portfolio of successful, progressive project management with at least ten years of experience including leadership roles in the execution of large-scale, concurrent projects.
  
• Demonstrated competency in resource and project management: budgeting, organizing work, providing leadership to staff, establishing measures for success, and managing to deliverables.
  
• Demonstrated experience with budgeting, change management, vendor management, project management methodology and business life cycle, mission/vision/strategy, project planning and organization, risk management and resource management.
  
• Ability to communicate effectively, verbally and in writing, to all levels of the organization.
  
• Ability to negotiate for competing resources and to generate consensus among multiple priorities.
  
• Proficient analytical and problem-solving skills, with the ability to analyze complex situations, learn quickly and synthesize corresponding solutions, options and action plans.
  
• Ability to develop and lead teams, including: hiring, goal setting, coaching and development of employees who may be in multiple locations or work remotely.
  
• Demonstrated experience supporting vendor sourcing efforts including participating in the RFP process, vendor due diligence, and providing details for contract creation.
  
• Ability to successfully work in fast-paced, multi-tasking, fluid environment with ever-changing priorities and has the ability to foster a collaborative working environment with all staff levels across the organization.
  
• Ability to identify issues, opportunities, and effective solutions and collaborate with other departments to improve processes and/or results. Strong facilitation skills, including the ability to resolve issues and build consensus among groups of diverse stakeholders.
  
• Demonstrated leadership and interpersonal skills and ability to effectively manage projects and vendor relationships. Ability to build strong relationships with key stakeholders, leadership, team and a variety of groups and individuals at all levels of the organization and have an executive presence. Proactively identify needs, issues and strategize with partners to solve business problems and inefficiencies with diplomacy and persuasiveness.
  

Normally to be proficient in the competencies listed above

Manager Risk Adjustment Campaign Execution would have a Bachelor's Degree in business, project management, healthcare or related field, and 10 years of project coordination/management experience including experience leading campaign operations and overseeing third party service providers, or an equivalent combination of education and experience. Certificate or training in Project Management a plus.

FTEs Supervised

1-5

Work Environment

• Work is primarily performed in an office or remote work environment.
• Travel may be required, either locally or out of state.
• Global travel may be required.

The expected hiring range for a Mgr Risk Adjustment Campaign Execution is $99,500.00 - $134,600.00 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 $93,000.00 to $153,000.00.

#LI-remote

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:

• medical, dental, and vision coverage for employees and their eligible family members
  
• annual employer contribution to a health savings account ($1,200 or $2,500 depending on medical coverage, prorated based on hire date)
  
• paid time off varying by role and tenure in addition to 10 company holidays
  
• up to a 6% company match on employee 401k 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)
  
• one-time furniture and equipment allowance for employees working from home
  
• up to $225 in Amazon gift cards for participating in various well-being activities. for a complete list see our External Total Rewards page.
  

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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