Risk Adjustment Provider Educator
Cambia Health Solutions job in Portland, OR
Provider Educator
Work a Hybrid schedule 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 Provider Educators is living our mission to make health care easier and lives better. As a member of the Risk Adjustment team, our Provider Educators are responsible for developing communications, content and engaging network providers in support of provider education objectives. - all in service of creating a person-focused health care experience.
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:
Provider Education Coordinator would have a 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 of experience in a HCC Coding Audit or Network Management role or equivalent combination of education and experience.
CPC and/or CRC credentials preferred
Skills and Attributes:
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, ICD10 diagnosis coding.
Knowledge of health insurance preferred, including medical and dental terminology, procedural and diagnosis coding, reimbursement methodologies and various provider network arrangements.
What You Will Do at Cambia:
Develops, coordinates, and drives risk adjustment education initiatives with network providers and acts 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 that have been identified through various operational reporting channels as a candidate for provider education engagement
Works with key leaders within the provider organization to engage with and drive successful performance of the provider engagement.
Assists senior leadership with special projects related to advancing Cambia's value based and innovative provider relationships.
Participates in definition of project deliverables, providing consultation, recommendations, and solutions, reviewing project mandates and directives to determine overall provider engagement approach
Leads, under the direction of management, in design and implementation of initiative related administrative policies and procedures and provides guidance and direction to the work team
Work Environment
No unusual working conditions.
Work primarily performed in an office environment.
Some travel may be required
The expected hiring range for a Provider Educator is $83,300.00 - $111,600.00 depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. The bonus target for this position is 10%. The current full salary range for this role is $78,000.00 to $128,000.00.
#LI-hybrid
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 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 Privacy Policy.
Auto-ApplyAI Scientist I (Healthcare)
Cambia Health job in Portland, OR
Hybrid (Office 3 days/wk - Onsite-Flex) 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 Applied AI Team is living our mission to make health care easier and lives better. AI Scientists work with various stakeholders to design, develop, and implement data-driven solutions. This position applies expertise in advanced analytical tools such as generative AI, machine learning, deep learning, optimization, and statistical modeling to solve business problems in the healthcare payer domain. AI Scientists work may focus on a particular area of the business such as clinical care delivery, customer experience, or payment integrity, or they may work across several areas spanning the organization. In addition to expertise in generative AI, machine learning, deep learning and analytics this role requires knowledge of data systems, basic software development best practices, and algorithm design.
AI Scientists work closely with AI team members in the Product and Engineering tracks to collaboratively develop and deliver models and data-driven products. AI Scientists also collaborate and communicate with business partners to design and develop data-driven solutions to business problems and interpret and communicate results to technical and non-technical audiences - all in service of making our members' health journeys easier.
If you're a motivated and experienced AI Scientist looking to make a difference in the healthcare industry, apply for this exciting opportunity today!
What You Bring to Cambia:
Qualifications and Certifications:
* Bachelor's degree (masters or PhD preferred) in a strongly quantitative field such as Computer Science, Statistics, Applied Mathematics, Physics, Operations Research, Bioinformatics, or Econometrics
* 0-3 years of related work experience
* Equivalent combination of education and experience
Skills and Attributes (Not limited to):
For all levels:
* Demonstrated knowledge of generative AI, machine learning and data science.
* Ability to use well-understood techniques and existing patterns to build, analyze, deploy, and maintain models.
* Effective in time and task management.
* Able to develop productive working relationships with colleagues and business partners.
* Strong interest in the healthcare industry.
Core Knowledge:
* Generative AI:Understanding of foundation models, transformer architectures, and techniques for working with large language models (LLMs). Experience with prompt engineering, fine-tuning approaches, and evaluation methods for generative models.
* Machine Learning:Strong mathematical foundation and theoretical grasp of the concepts underlying machine learning, optimization, etc. (see below). Demonstrated understanding of how to structure simple machine learning pipelines (e.g, has prepared datasets, trained and tested models end-to-end).
* Data:Strong foundation in data analysis.
* Programming:Strong python programming skills. Familiarity with standard data science packages. Familiarity with standard software development best practices. Strong SQL skills a plus.
* Algorithms:Understanding of standard algorithms and data structures (ex. search and sort) and their analysis.
* Core Knowledge Details and Examples (meant to be representative, not exhaustive; entry level roles are expected to have hands-on experience training and testing AI models, solid mathematical understanding and computer science fundamentals)
Generative AI
* Large Language Models (LLMs) and their capabilities (e.g, in-context learning, few-shot learning, zero-shot learning)
* Prompt engineering techniques and best practices
* Fine-tuning approaches (e.g, full fine-tuning, parameter-efficient methods like LoRA, QLoRA)
* Retrieval-Augmented Generation (RAG) and knowledge integration
* Evaluation methods for generative models (e.g, perplexity, BLEU, ROUGE, human evaluation)
* Alignment techniques (e.g, RLHF, constitutional AI, red-teaming)
* Multimodal generative models (text-to-image, text-to-video, multimodal understanding)
* Responsible AI considerations specific to generative models (e.g, bias, hallucinations, safety)
* Familiarity with Gen AI frameworks and tools (e.g, Hugging Face and LangChain)
Machine Learning
* Classic ML algorithms (e.g, linear and logistic regression, decision and boosted trees, SVM, collaborative filtering, ranking)
* Approaches (e.g, supervised, semi-supervised, unsupervised, reinforcement learning, regression, classification, time series modeling, transfer learning)
* Foundational ML concepts such as objective functions, regularization and over fitting
* Data partitions (train/dev/test) and model development
* Hyperparameter tuning and grid search
* Evaluation concepts (metrics, feature importance, etc.)
* Familiarity with standard python packages (scikit-learn, XGBoost, TensorFlow, PyTorch, etc.)
* Familiarity with structure of machine learning pipelines
* Deep Learning (basic understanding expected at all levels)
* Activation functions
* Optimization/Gradient Decent
* Common architectures (CNN, RNN, LSTM, GAN, etc.)
* Embeddings
* Familiarity with specializations (sequence modeling/NLP/computer vision)
Math
* Linear Algebra
* Discrete math
* Probability and Statistics
* Calculus
Data
* Research and experiment design
* Visualization with data
* Answering questions with data
What You Will Do at Cambia (Not limited to):
Note that these responsibilities are representative but not exhaustive. Higher-level roles involve successively stronger degrees of initiative taking and innovation beyond the core responsibilities listed here.
* Researches, designs, develops, and implements data-driven models and algorithms using generative AI, machine learning, deep learning, statistical, and other statistical modeling techniques.
* Trains and tests models, and develops algorithms to solve business problems.
* Adheres to standard best-practices and establishes principled experimental frameworks for developing data-driven models.
* Develops models and performs experiments and analyses that are replicable by others.
* Uses open-source packages and managed services when appropriate to facilitate model development
* Identifies, measures, analyzes, and visualizes drivers to explain model performance (e.g, feature importance, interpretability, bias and error analysis), both offline (in the development phase) and online (in production).
* Uses appropriate metrics and quantified outcomes to drive AI model and algorithm improvements.
The expected hiring range for The AI Scientist I is $135k-$145k, 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 position is $104k Low/ $169k MRP
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 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 Privacy Policy.
Auto-ApplySales, Account Executive, Philips ECG Solutions (Northwest -Portland, OR)
Portland, OR job
Job TitleSales, Account Executive, Philips ECG Solutions (Northwest -Portland, OR) Job Description
Sales, Account Executive, Philips ECG Solutions (Northwest-Portland)
Philips ECG Solutions enables a new standard of cardiac care across the continuum by connecting care from home to hospital and hospital to home-all so your customers can deliver patient-centered heart care everywhere. Bring your sales talents to this winning Ambulatory Monitoring & Diagnostics (AM&D) division within Philips!
Your role:
As a Philips ECG Solutions Account Executive, you will primarily be responsible for orchestrating the sales process from lead identification, prospect new business, maintain and grow existing client accounts and ensure sales strategies meet revenue objectives while promoting ECG Solutions products and services.
You will be a part of a dynamic sales organization, calling on cardiologists, electrophysiologists, hospital administrators, in both the office and hospital and report to the Regional Sales Leader.
You will drive sales revenue and overall market share inside the territory as well as nurturing existing accounts. You will arrange appointments, equipment demonstrations and eventual sales meetings of Philips ECG Solutions products and communicate the company's competitive differentiation and value proposition to enhance sales and convert competitive accounts
This is a field based role and will require daily travel in the territory (Northwest - OR, Vancouver, WA, NE WA, and Alaska.
You're the right fit if:
Minimum 2 years of sales experience reflecting a track record of proven success within the Medical Device and / or Biotechnology arena, preferably in cardiology. Demonstrated track record of consistently meeting or exceeding an annual quota of more than $1M.
Your skills include advanced selling capability that showcases commitment to sales and company strategy, customer satisfaction, negotiation and the ability to close. Experience and success in hunting for new business; experience selling in hospitals or IDNs preferred. Strong communication and presentation skills required.
You have a Bachelor's degree in Business Administration, Marketing or health related field; or equivalent combination of education and experience.
You must be able to successfully perform the following minimum Physical, Cognitive and Environmental job requirements with or without accommodation for this Sales position.
About Philips
We are a health technology company. We built our entire company around the belief that every human matters, and we won't stop until everybody everywhere has access to the quality healthcare that we all deserve. Do the work of your life to help improve the lives of others.
Learn more about our business.
Discover our rich and exciting history.
Learn more about our purpose.
Learn more about our culture.
Philips Transparency Details
Total Target Earnings is composed of base salary + target incentive. At 85% to 120% performance achievement, the Target Earning potential is $165,000 to $200,000 annually, plus company fleet/car. Total compensation may be higher or lower dependent upon individual performance.
Total Target Earnings is composed of base salary + target incentive, plus company fleet/car, generous PTO, 401k (up to 7% match), HSA (with company contribution), stock purchase plan, education reimbursement and much more. Details about our benefits can be found here.
Additional Information
US work authorization is a precondition of employment. The company will not consider candidates who require sponsorship for a work-authorized visa, now or in the future.
Company relocation benefits will not be provided for this position. For this position, you must reside in or within commuting distance to Portland, OR.
#LI-Remote
#LI-Field
#ConnectedCare
This requisition is expected to stay active for 45 days but may close earlier if a successful candidate is selected or business necessity dictates. Interested candidates are encouraged to apply as soon as possible to ensure consideration.
Philips is an Equal Employment and Opportunity Employer including Disability/Vets and maintains a drug-free workplace.
Auto-ApplySr. Program Delivery Professional IWHA-Interoperability
Salem, OR job
**Become a part of our caring community and help us put health first** The Senior Program Delivery Professional strategically identifies, develops, and implements programs that influence providers, members or market leadership towards value-based relationships and/or improved quality metrics. The Senior Program Delivery Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
The Program Delivery Professional - IHWA Interoperability plays a key role in driving seamless data integration and collaboration within the In-Home Health and Wellbeing Assessment (IHWA) team and across interoperability initiatives. Serving as a business subject matter expert (SME), this individual partners closely with internal and external stakeholders, as well as the Interoperability team, to advance program objectives.
Key responsibilities include collaborating with leaders on implementation planning, reviewing and communicating program results, and contributing to the ongoing improvement of processes and automation. The role also begins to influence departmental strategy and requires independent decision-making on moderately complex to complex technical matters related to project components. Work is performed without direct supervision, with considerable latitude in determining objectives and approaches to assignments.
The ideal candidate demonstrates a collaborative approach, a strong interest in technology solutions, and a commitment to continuous process improvement.
**Use your skills to make an impact**
**Required Qualifications**
+ Minimum three, (3) years of IT project management or business process automation, experience in technology solutions.
+ Excellent communication skills, both oral and written
+ Proven experience in interoperability or data integration within a healthcare or technology setting.
+ Strong problem-solving skills with demonstrated success in process improvement initiatives and process automation.
+ Familiarity with various technology solutions and interest in exploring new innovations.
+ Excellent collaboration, and stakeholder management abilities.
+ Experience with managing and monitoring successful and impactful projects.
+ Self-starter with the ability to work independently and as part of a team.
+ Futuristic and broad thinker with attention to detail and downstream impacts.
**Preferred Qualifications**
+ Bachelor's degree in Information Technology, Computer Science, Information Systems, or a related field.
+ Experience with EHR integration or usage.
+ Experience with AI integration.
+ Experience automating business processes.
+ PMP certification a plus
+ Knowledge and experience in health care environment/managed care
+ Strong analytical skills
**Workstyle** : Open for Hybrid or Remote Work at Home
**Location:** U.S.
**Schedule:** 8:00 AM - 5:00 PM Eastern Time Monday through Friday
**Travel:** occasional onsite as business needs require.
**Work at Home Guidance** To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership. Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
**SSN Alert** Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from ******************** with instructions on how to add the information into your official application on Humana's secure website.
**Interview Format** As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$86,300 - $118,700 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 01-08-2026
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
Easy ApplyMedical Director - Nat'l UM IP (4x10 hr)
Salem, OR job
**Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All work occurs with a context of regulatory compliance, and work is assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical reference materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements, and will understand how to operationalize this knowledge in their daily work.
The Medical Director's work includes computer based review of moderately complex to complex clinical scenarios, review of all submitted clinical records, prioritization of daily work, communication of decisions to internal associates, and possible participation in care management. The clinical scenarios predominantly arise from inpatient or post-acute care environments. Has discussions with external physicians by phone to gather additional clinical information or discuss determinations regularly, and in some instances these may require conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient services and equipment, within their scope.
The Medical Director may speak with contracted external physicians, physician groups, facilities, or community groups to support regional market priorities, which may include an understanding of Humana processes, as well as a focus on collaborative business relationships, value based care, population health, or disease or care management. Medical
**Use your skills to make an impact**
**Responsibilities**
The Medical Director provides medical interpretation and determinations whether services provided by other healthcare professionals are in agreement with national guidelines, CMS requirements, Humana policies, clinical standards, and (in some cases) contracts. The ideal candidate supports and collaborates with other team members, other departments, Humana colleagues and the Regional VP Health Services. After completion of mentored training, daily work is performed with minimal direction. Enjoys working in a structured environment with expectations for consistency in thinking and authorship. Exercises independence in meeting departmental expectations, and meets compliance timelines.
**Required Qualifications**
+ MD or DO degree
+ **4 x 10h (Fri, Sat, Sun, Mon)**
+ 5+ years of direct clinical patient care experience post residency or fellowship, which preferably includes some experience in an inpatient environment and/or related to care of a Medicare type population (disabled or >65 years of age).
+ Current and ongoing Board Certification an approved ABMS Medical Specialty
+ A current and unrestricted license in at least one jurisdiction and willing to obtain additional license, if required.
+ No current sanction from Federal or State Governmental organizations, and able to pass credentialing requirements.
+ Excellent verbal and written communication skills .
+ Evidence of analytic and interpretation skills, with prior experience participating in teams focusing on quality management, utilization management, case management, discharge planning and/or home health or post acute services such as inpatient rehabilitation.
**Preferred Qualifications**
+ Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management.
+ Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance.
+ Experience with national guidelines such as MCG or InterQual
+ Internal Medicine, Family Practice, Geriatrics, Hospitalist, Emergency Medicine clinical specialists
+ Advanced degree such as an MBA, MHA, MPH
+ Exposure to Public Health, Population Health, analytics, and use of business metrics.
+ Experience working with Case managers or Care managers on complex case management, including familiarity with social determinants of health.
+ The curiosity to learn, the flexibility to adapt and the courage to innovate
**Additional Information**
Typically reports to a Regional Vice President of Health Services, Lead, or Corporate Medical Director, depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an assigned market, member population, or condition type. May also engage in grievance and appeals reviews. May participate on project teams or organizational committees.
\#physiciancareers
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$223,800 - $313,100 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 04-30-2026
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
Administrative Assistant I - IV, DOE
Cambia Health job in Portland, OR
Hybrid within Salt Lake City, UT; Medford, OR; Portland, OR; Lewiston, ID; Boise, ID; Burlington, WA; Renton, WA; Spokane, WA; Vancouver, WA 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 Administrative Assistants are living our mission to make health care easier and lives better. As a member of the HealthPlan Operations team, our Administrative Assistants provide centralized operational support for multiple Vice Presidents and Directors, handling meeting coordination, document preparation, communication management, and expense tracking. This critical role enables senior leadership to focus on strategic initiatives while ensuring standardized administrative processes and operational continuity across the department - all in service of creating a person-focused health care experience.
Do you excel at managing multiple priorities while supporting diverse leadership needs in a fast-paced environment? Are you passionate about creating operational efficiency and enabling others to focus on strategic work through exceptional administrative support? Then this role may be the perfect fit.
What You Bring to Cambia:
Qualifications:
Administrative Assistant I:
* 2 plus years increasingly responsible administrative assistant/secretarial experience
Administrative Assistant II:
* 2 - 3 plus years increasingly responsible administrative assistant/secretarial experience
Administrative Assistant III:
* 4 plus years increasingly responsible administrative assistant/secretarial experience
Administrative Assistant IV:
* 5 plus years increasingly responsible administrative assistant/secretarial experience and executive level support experience
Skills and Attributes:
* Familiarity with medical terminology, healthcare claims processes, and clinical workflows is a plus
* Advanced proficiency in Microsoft Office software, SharePoint administration, and collaboration tools
* Experience with AI tools and technologies to enhance productivity and decision-making in professional settings
* Demonstrated ability to provide administrative support to multiple senior executives simultaneously, including complex calendar coordination across departments and time zones
* Excellent written and oral communication skills with strong organizational abilities and initiative
* Experience with license management, regulatory compliance tracking, and vendor relationship management
* Event planning, coordination, and newsletter/communication management experience
What You Will Do at Cambia:
* Provide complex administrative and confidential support including document preparation, proofreading, correspondence management, and screening communications for multiple senior leaders
* Schedule and coordinate calendars, appointments, meetings, and travel arrangements across 4 Associate Directors, 2 Directors, and multiple managers
* Record, distribute meeting minutes, and manage follow-up actions to ensure accountability and continuity
* Maintain expense records, compile reports, and assist with budget preparation and tracking
* Compose, initiate, and manage correspondence, memoranda, and reports on behalf of leadership
* Lead special projects including conferences, presentations, and data compilation requiring research and coordination
* Provide backup support to other administrative staff to ensure seamless departmental operations
Work Environment
* Duties are performed primarily in an office environment with an expectation of being in the office a minimum of 3 days a week
The expected hiring range for the Administrative Assistant I is $17.75 - $24.00/hour depending on skills, experience, education, and training; relevant licensure / certifications; and performance history. The bonus target for this position is 5%. The current full salary range for this role is $17.75 - $31.20/hour.
The expected hiring range for the Administrative Assistant II is $19.00 - $26.40/hour depending on skills, experience, education, and training; relevant licensure / certifications; and performance history. The bonus target for this position is 5%. The current full salary range for this role is $19.00 - $34.40/hour.
The expected hiring range for the Administrative Assistant III is $21.30 - $26.70/hour depending on skills, experience, education, and training; relevant licensure / certifications; and performance history. The bonus target for this position is 5%. The current full salary range for this role is $21.30 - $34.80/hour.
The expected hiring range for the Administrative Assistant IV is $24.00 - $31.90/hour depending on skills, experience, education, and training; relevant licensure / certifications; and performance history. The bonus target for this position is 5%. The current full salary range for this role is $24.00 - $41.50/hour.
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 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 Privacy Policy.
Auto-ApplyAssociate Actuary
Salem, OR job
**Become a part of our caring community and help us put health first** The Associate Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions. Establishes metrics, provides data analyses, and works directly to support business intelligence. Evaluates industry, economic, financial, and market trends to forecast the organization's short, medium and long-term financial and competitive position. The Associate Actuary, Analytics/Forecasting work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
The Associate Actuary, Analytics/Forecasting ensures data integrity by developing and executing necessary processes and controls around the flow of data. Collaborates with stakeholders to understand business needs/issues, troubleshoots problems, conducts root cause analysis, and develops cost effective resolutions for data anomalies. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.
**In addition, the Associate Actuary will:**
+ Support long term projects aimed at advancing technical maturity, process efficiency, and forecasting accuracy. We are looking for creativity, curiosity, and a desire to explore and influence uncharted territory.
+ Conduct independent research, collaborate across many teams/departments, and require strong communication skills to be successful in the job.
**Use your skills to make an impact**
**Required Qualifications**
+ Bachelor's Degree
+ Associate of Society of Actuaries (ASA) designation
+ Meets eligibility requirements for Humana's Actuarial Professional Development Program (APDP)
+ MAAA
+ Strong communication skills
+ Demonstrated ability to communicate technical information with audiences not in the actuarial space
+ Must be passionate about contributing to an organization focused on continuously improving consumer experiences
+ 3+ years health industry experience with ASA, or 1+ years health industry experience with FSA
+ 2+ years SQL experience, or equivalent skillset
**Preferred Qualifications**
+ Medicare Advantage background
+ Creative, high degree of self-accountability
+ Experience in Python, PowerApps, and PowerBI
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$106,900 - $147,000 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 12-30-2025
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
Critical Care Nurse - Clinical Solution Specialist (Travel: Pacific Northwest)
Portland, OR job
Job TitleCritical Care Nurse - Clinical Solution Specialist (Travel: Pacific Northwest) Job Description
Clinical Solution Specialist - Patient Monitoring (Travel: Pacific Northwest)
Bring your passion for patient care and technology to this role where you'll be responsible for providing clinical customer support as the clinical application knowledge expert. You'll facilitate solutions design, optimization, configuration, and delivery of Philips Hospital Patient Monitoring (HPM) products to ensure a quality customer experience.
Your role:
Serving as a clinical resource to Philips HPM customers, working closely with the field service, sales, and project management organizations throughout a multiphase implementation and go-live process - establishing and maintaining strong working relationships with key internal partners and customers to enable a successful implementation team.
Understanding customer goals and developing plans to support clinical solutions implementation and usage - delivering clinical services to customers that are consultative, advanced, and focused on workflows and optimization.
Managing the clinical aspects of an implementation to include assessing workflows, evaluating education needs, creating education plans, determining custom configurations requirements, planning and delivering equipment and application education, supporting first customer use, encouraging ongoing adoption of change, and optimizing use of complex monitoring solutions.
Understanding the clinical implications of technical implementations (including networks and clinical informatics systems); applying product and clinical knowledge to troubleshoot and solve problems.
Approximately 90% travel across the district is required. The average driving time is 1-4 hours daily. Occasional overnight stays and travel by air/train/bus may be required. Further support across the zone is required, and occasional national travel may be required.
You're the right fit if:
You've acquired 4+ years of experience as a Registered Nurse in a hospital environment. Prior clinical training and adult education delivery experience is highly preferred.
Your skills include experience in an Intensive Care Unit (ICU), Critical Care Unit (CCU), Emergency Room (ER), Operating Room (OR), Neonatal Intensive Care Unit (NICU), and/or Pediatric Intensive Care Unit (PICU) settings. Knowledge of Philips IntelliVue monitoring equipment and applications preferred.
You have a Bachelor of Science in Nursing degree or equivalent licensure to practice nursing (Registered Nurse); must be able to provide verification for current/active license. Certified Technical Trainer Plus (CTT+) and/or Virtual Certified Technical Trainer Plus (VCTT+) is preferred.
You're passionate about technology and education related to patient care.
You have excellent verbal and written communication and presentation skills.
You must be able to successfully perform the following minimum Physical, Cognitive and Environmental job requirements with or without accommodation for this Clinical position.
You must be able to:
Work in an office/home office and/or remote setting, as well as in a hospital/healthcare environment; adhere to requirements.
Work flexible hours (based on business needs).
Wear all required personal protective equipment.
May be required to comply with vendor credentialing.
How we work together
We believe that we are better together than apart. For our office-based teams, this means working in-person at least 3 days per week. Onsite roles require full-time presence in the company's facilities. Field roles are most effectively done outside of the company's main facilities, generally at the customers' or suppliers' locations.
This is a field role.
About Philips
We are a health technology company. We built our entire company around the belief that every human matters, and we won't stop until everybody everywhere has access to the quality healthcare that we all deserve. Do the work of your life to help improve the lives of others.
Learn more about our business.
Discover our rich and exciting history.
Learn more about our purpose.
Learn more about our culture.
Philips Transparency Details
The annual pay range for this position in WA is $92,000 to $147,000.
The annual pay range for this position in OR is $87,000 to $140,000.
This role also includes company fleet/car, training, and advancement opportunities. The actual base pay offered may vary depending on multiple factors including job-related knowledge/skills, experience, business needs, geographical location, and internal equity.
In addition, other compensation such as an annual incentive plan, sales commission, or long-term incentives may be offered. Employees are eligible to participate in our comprehensive Philips Total Rewards benefits program, which includes a generous PTO, 401k (up to 7% match), HSA (with company contribution), stock purchase plan, education reimbursement, and much more. Details about our benefits can be found here.
At Philips, it is not typical for an individual to be hired at or near the top end of the range for their role and compensation decisions are dependent upon the facts and circumstances of each case.
Additional Information
US work authorization is a precondition of employment. The company will not consider candidates who require sponsorship for a work-authorized visa, now or in the future.
For this position, you must reside in
or
within commuting distance to Seattle/Portland areas.
This requisition is expected to stay active for 45 days but may close earlier if a successful candidate is selected or business necessity dictates. Interested candidates are encouraged to apply as soon as possible to ensure consideration.
Philips is an Equal Employment and Opportunity Employer including Disability/Vets and maintains a drug-free workplace.
Auto-ApplyContent Designer
Salem, OR job
**Become a part of our caring community and help us put health first** Humana is committed to innovative digital experiences that improve our members' quality of life and the interactions they have with us. We are looking for a content designer who is passionate about digital content and the critical role it plays in customer experience. As a member of Humana's Consumer Digital team, you will be responsible for defining and creating content that ensures people get the information they need to successfully choose and use their plans.
By partnering with leaders from business, research, design, technology, marketing and legal and compliance, you will ensure we get the right information, in the right ways, at the right times to audiences that include consumers, members, providers, employers and agents.
As the Content Designer, you will:
+ Create content strategies and direct information hierarchy, content types, voice and tone to ensure content is aligned to established audience and business objectives, research insights, brand standards, legal and compliance requirements, accessibility best practices and digital standards
+ Collaborate with other UX experts on content organization, navigation, site maps and information architecture
+ Seek simplicity, distilling complex concepts into clear, concise and contextual content and taxonomies
+ Create and manage copy for all steps of the digital experience, including headlines, product summaries and comparison, alt text, microcopy, buttons, navigation and error messaging
+ Develop tools such as content matrices and editorial calendars to track and manage content updates
+ Regularly audit and inventory online content to identify gaps in quality, compliance, standards and branding
+ Continuously improve digital content, including partnering to identify research needs, mining user data and insights and conducting competitive assessments
+ Maintain Humana digital content guidelines, standards, tools and processes
**Use your skills to make an impact**
**Required Qualifications**
+ Bachelor's Degree in English, Journalism or similar field
+ At least 3+ years of content strategy and UX writing experience
+ E-commerce experience
+ Experience writing and optimizing content for a variety of content types, digital channels and secure portals
+ Well-organized and detail-oriented, capable of handling multiple projects simultaneously, and able to move between strategic and tactical work
+ Familiar with working in a regulatory environment that requires legal and compliance oversight
+ Excellent verbal, written, and presentation skills
+ Experience with collaboration and agile technology, such as Jira
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$65,000 - $88,600 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 01-01-2026
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
Risk Management BSA I, II, III
Cambia Health job in Vancouver, WA
Risk Management - Business System Analyst I, II or III Work a Hybrid work schedule 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 Business System Analysts (BSA) is living our mission to make health care easier and lives better. As a member of the Risk Management team, our BSAs are responsible for complying with CMS mandates to submit Enrollment, Medical Claim and Pharmacy Claims data for Reinsurance Reimbursement, Member Risk Assessment and Risk Corridor calculations - all in service of making our members' health journeys easier.
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:
The Risk Management BSA I: Bachelor's degree in Business, Data Analysis or other related field plus 2 years' experience with data analysis, process modeling or equivalent combination of education and experience.
The Risk Management BSA II: Bachelor's degree in Business, Data Analysis or other related field plus 2 - 4 years' experience with data analysis, process modeling or equivalent combination of education and experience.
The Risk Management BSA III: Bachelor's degree in Business, Data Analysis or other related field plus 5 - 7 years' experience with data analysis, process modeling or equivalent combination of education and experience.
Skills and Attributes:
* Experience aggregating, reviewing and extracting data from various sources to create larger, more complex data sets.
* Good research and problem solving skills including the ability to determine action steps and remediation actions to resolve issues.
* Ability to accurately complete activities within established deadlines. Ability to work under pressure and partner with others.
* Good written and verbal communication skills including the ability to work with internal and external partners.
* Proficiency with Microsoft Office software programs and general experience database query tools.
* Ability to update process documentation to ensure activities and outputs align with CMS guidelines.
* General knowledge of medical terminology and procedure coding.
* Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired.
Additional Requirements for BSA II:
* Ability to identify problems, develop solutions and implement actions with minimal supervision.
* Ability to develop and modify data queries for use in the CMS data submission process. Works with internal partners to test and validate the effectiveness of new or modified queries.
Additional Functions and Outcomes for BSA III:
* Tracks and monitors CMS data submission guidelines. Reviews and verifies updates made to process documentation align with data submission guidelines. Acts as a resources to others on the Risk Management team.
* Updates business partner groups (enrollment, medical claims, pharmacy claims, etc.) on annual changes to CMS submission requirement.
What You Will Do at Cambia:
* Extracts required information from the source systems into a staging area and performs validation checks based on CMS Edge Server Business Rules.
* Submits data to the Edge Server via an established translation process.
* Reviews data validation reports that are received back from CMS and any errors are investigated and corrected prior to data being resubmitted.
* Communicates with internal/external customers to resolve any errors within the source systems for any of the above areas.
* Encourages ongoing innovation and looks for opportunities to enhance the quality and efficiency of departmental processes.
* Assists in the training and communicating system changes for end-users and other affected staff.
* Schedules, organizes and prioritizes work to ensure timely completion of all assigned activities.
* Maintins process documentation and ensures data submission and validation activities align with CMS guidelines.
Additional Functions and Outcomes for BSA II:
* Partners with Risk Management leadership to prioritize data submission activities and resolve issues in a timely manner.
* Creates new data queries for the data submission process.
Additional Functions and Outcomes for BSA III:
* Communicates to the enrollment, medical claims, pharmacy claims, and supplemental condition code business partners as to what the requirements are for CMS submission.
* Completes technical peer review of process improvements and ad hoc departmental projects.
Work Environment
* Work performed in office environment or can be remote.
* Travel rarely required, locally or out of state.
* May be required to work outside normal hours.
The expected hiring range for a Risk Management BSA I is $62,100.00 - $82,800.00 depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. The bonus target for this position is 5%. The current full salary range for this role is $57,000.00 to $95,000.00.
The expected hiring range for a Risk Management BSA II is $68,900.00 - $93,150.00 depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. The bonus target for this position is 10%. The current full salary range for this role is $64,000.00 to $106,000.00.
The expected hiring range for a Risk Management BSA III is $75,700.00 - $102,350.00 depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. The bonus target for this position is 10%. The current full salary range for this role is $71,000.00 to $116,000.00.
#LI-hybrid
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 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 Privacy Policy.
Auto-ApplySemantic Architect
Cambia Health Solutions job in Portland, OR
SEMANTIC ARCHITECT (HEALTHCARE) Telecommute (Possible 2026 Return to office) - 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 Data & Analytics Engineering Team is living our mission to make health care easier and lives better. We're seeking a seasoned Data and Analytics Engineer with extensive semantic data architecture experience to design and implement, expand, and enhance our existing semantic layer within our Snowflake data platform to support AI-driven semantic intelligence and BI for our health insurance payer organization. The role will focus on creating a robust, scalable semantic framework that enhances data discoverability, interoperability, and usability for AI tools, enabling advanced analytics, predictive modeling, and actionable insights. - all in service of making our members' health journeys easier.
If you're a motivated and experienced Semantic Professional looking to make a difference in the healthcare industry, apply for this exciting opportunity today!
What You Bring to Cambia:
Qualifications and Certifications:
Bachelor's degree in computer science, Mathematics, Business Administration, Engineering, or a related field
8 years relevant experience in a multi-platform environment, including, but not limited to application development or database development
At least 2 years working with Snowflake or similar cloud data platforms
Equivalent combination of education and experience
What You Will Do at Cambia (Not limited to):
Enterprise Semantic Layer: Design, develop, extend, and maintain semantic data models on Snowflake to standardize data definitions, relationships, and ontologies for healthcare data (e.g., claims, member data, provider data).
Data Integration: Collaborate with data engineers to integrate structured and unstructured data from internal (e.g., claims systems, EHRs) and external sources into the semantic layer. When necessary, develop and optimize ETL/ELT pipelines to populate the semantic layer, integrating data from diverse sources (e.g., claims, member data, third-party feeds) using Snowflake's capabilities.
Analytics and AI Enablement: Ensure the semantic layer supports analytics, BI, and AI use cases, such as predictive analytics for risk stratification, fraud detection, and member engagement.
Governance and Standards: Work closely with our Data Governance organization to develop governance policies, metadata standards, and ontologies to ensure consistency, compliance, and interoperability.
Stakeholder Collaboration: Work with business analysts, data modelers, data engineers, and business users to translate business requirements into semantic data models that support self-service analytics and enable AI analysis and agents.
Performance Optimization: Optimize semantic models for query performance and scalability on Snowflake, taking advantage of Snowflake's current and future features.
Documentation and Training: Document semantic models and provide training to end-users and technical teams on leveraging the semantic layer.
Skills and Attributes (Not limited to):
Preferred: Experience with FHIR, HL7, or other healthcare data standards; familiarity with tools like Collibra or Informatica for metadata management.
Expertise in semantic technologies, including Snowflake semantic views, MicroStrategy, AtScale, or Business Objects universes, and familiarity with healthcare ontologies (e.g., SNOMED, LOINC, ICD-10).
Strong understanding of analytics workflows and their data requirements.
Experience with data governance, metadata management, and compliance in healthcare.
Proficiency in dimensional data modeling.
Proficiency in SQL and experience with Snowflake-specific features.
Experience using code repositories such as GitLab or GitHub and CI/CD-based deployment.
Excellent communication skills to bridge technical and business teams.
Preferred: Experience with FHIR, HL7, or other healthcare data standards; familiarity with tools like Collibra or Informatica for metadata management.
The expected hiring range for The Semantic Architect II is $135k-$145k and Semantic Architect III is $160k-$175k depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. The bonus target for the Architect II is 15% and Architect III is 25%. The current full salary range for the Architect II position is $113k Low/ $142k MRP / $185k High. The Architect III salary range is $138k Low/ $173k MRP / $225k
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 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 Privacy Policy.
Auto-ApplySocial Worker Home Health
Lake Oswego, OR job
Become a part of our caring community and help us put health first The Medical Social Worker participates in the interdisciplinary care provided to home health patients. The Medical Social Worker functions to evaluate and develop a plan of care personalized to fit the patient's emotional and social needs. The Medical Social Worker provides direction and supervision of the Social Worker Assistant as required and when involved in the patient's plan of care. The Medical Social Worker works within CenterWell Home Health's company-specific policy and procedures, applicable healthcare standards, governmental laws, and regulations.
* Assesses the patient's social and emotional state as it relates to his or her illness or injury, needs for care and his or her response to such treatment, and adjustments to care.
* Assesses any relationships of the patient's medical and nursing needs in the home setting, financial resources, and available community resources.
* Provides any appropriate action to obtain available community resources to assist in resolving issues that may be impeding the patient's recovery.
* Instructs patients and families in treating and coping with social and emotional response connected with Provides ongoing assessment of patient and family needs and responses to teaching
* Assists the physician and other health team members in understanding the significant social and emotional factors related to the patient's health Participates in the development and periodic re-evaluation of the physician's Plan of Care for the patient.
* Observes, records, and reports changes in patients' condition and response to treatment to the Clinical Manager and the Participates in the discharge planning process
* Participates as a member of the interdisciplinary care team in care coordination activities and acts as a resource to other health team members in the identification and resolution of patient needs
* Supervises instructs and evaluates the performance of the Social Work Assistant (BSW) to assure that all medical social services are provided to patients in compliance with Company, government, and professional standards
* Maintains and submits documentation as required by the company and/ or facility including any case conferences, patient/physician community contacts, visit reports progress notes, and confers with other health care disciplines in providing optimum patient care.
Use your skills to make an impact
Required Skills/Experience
* Masters or doctoral degree from a school of social work accredited by the Council on Social Work Education.
* Social Worker licensure in the state of practice; if required by state law or regulation.
* A valid driver's license, auto insurance, and reliable transportation are required.
* Proof of current CPR certification
* Minimum of one year of experience as a social worker in a health care setting, home health, and/or hospice.
* Knowledge of and the ability to assist with discharge planning needs, and to obtain community resources (housing, shelter, funeral/memorial service arrangements, legal, information and referral, state/federal financial and medication programs, and eligibility.
* Excellent oral and written communication and interpersonal skills.
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$53,700 - $72,600 per year
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About Us
About CenterWell Home Health: CenterWell Home Health specializes in personalized, comprehensive home care for patients managing a chronic condition or recovering from injury, illness, surgery or hospitalization. Our care teams include nurses, physical therapists, occupational therapists, speech-language pathologists, home health aides, and medical social workers - all working together to help patients rehabilitate, recover and regain their independence so they can live healthier and happier lives.
About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Senior Manager, MarketPoint Sales - Raleigh Durham, NC.
Salem, OR job
**Become a part of our caring community and help us put health first** With over 10 million sales interactions annually, Humana understands that while great products are important, it's the quality of our service that truly defines us. We know that when our members and prospects have delightful and memorable experiences, it strengthens their connection with us and enables us to put their Health First. After all, a health services company that has multiple ways to improve the lives of its customers is uniquely positioned to put those customers at the center of everything it does.
Are you passionate about the Medicare population, looking for a role in management with the ability to directly impact your own income potential? If so, we are looking for licensed, highly motivated and self-driven individuals to join our team. Our Senior Manager, Medicare Sales, motivates and drives a team of Medicare Sales Field Agents who sell individual health plan products and educate beneficiaries on our services in a field setting. Our teams also sell Life, Annuity, Indemnity, Dental, Vision, Prescription plans, and more.
Humana has an inclusive and diverse culture welcoming candidates with multilingual skill sets to service our consumers.
**This role is** **field** **based, and you will be out and about in the field in the Raleigh** **Durham, NC.** **area working with your team and meeting members face to face. You must reside in Raleigh** **Durham, NC.** **area or be willing to relocate to the area.**
In this **field** position, you will; coach, mentor, educate, motivate and train a team of sales individuals. The Senior Manager, Medicare Sales, must have a solid understanding of the market they serve, how to resolve operational problems and provide creative solutions to increase sales while following CMS guidelines. This role also involves cultivating, maintaining, and building relationships with Humana's customers, both internal and external business partners, along with the community we serve through telephonic, virtual, and face-to-face interactions with individuals and groups. Other responsibilities include developing marketing budgets, and looking for branding opportunities.
**Use your skills to make an impact**
**Required Qualifications**
+ **Must reside in the** **Raleigh** **Durham, NC.** **area or be willing to relocate**
+ **Active Health & Life Insurance Licenses**
+ 2 or more years of sales leadership experience
+ 6 or more years of experience working in the insurance industry
+ Must be able to travel up to 50% of the time
+ Ability to lead a team of sales associates and train them in successful sales techniques, educational presentation skills, utilizing technology tools as well as building relationships with communities and medical providers
+ Strong aptitude for technology with proficiency in MS Office products, various CRM platforms, and various iPhone app capabilities
+ Must be a strong leader, strong producer
+ Strong organizational, interpersonal, communication and presentation skills
+ Ability to adapt and overcome when necessary
+ Community Engagement/Grassroots experience in marketing Medicare plans in the community
+ Must be passionate about contributing to an organization focused on continuously improving consumer experiences
+ This role is part of Humana's Driver safety program and therefore requires an individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits
**Preferred Qualifications**
+ Bachelor's Degree
+ Prior experience working in Medicare and the health solutions industry
+ Engaged with the community through service, organizations, activities and volunteerism
+ Project management background or certification a plus
+ Bilingual with the ability to speak, read and write without limitations or assistance
**Humana Perks:**
Full time associates enjoy:
+ Base salary with a competitive commission structure
+ Medical, Dental, Vision and a variety of other supplemental insurances
+ Paid time off (PTO) & Paid Holidays
+ 401(k) retirement savings plan
+ Tuition reimbursement and/or scholarships for qualifying dependent children.
+ And much more!
**Social Security Task:**
Alert: Humana values personal identity protection. Please be aware that applicants being considered for an interview will be asked to provide a social security number, if it is not already on file. When required, an email will be sent from ******************** with instructions to add the information into the application at Humana's secure website.
**Virtual Pre-Screen:**
As part of our hiring process for this opportunity, we will be using exciting virtual pre-screen technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information for you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected for a virtual pre-screen, you will receive an email and text correspondence inviting you to participate in a HireVue interview. In this virtual pre-screen, you will receive a set of questions to answer. You should anticipate this virtual pre-screen to take about 10-15 minutes.
\#MedicareSalesManager \#MedicareSalesReps
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$77,000 - $105,100 per year
This job is eligible for a commission incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 01-30-2026
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
Easy ApplyLead Citrix Systems Engineer - Network/Virtualization
Salem, OR job
**Become a part of our caring community and help us put health first** The Lead Systems Engineer is responsible for design, analysis, configuration and maintenance of complex systems software solutions in a virtual environment, based on a thorough knowledge of systems engineering and programming concepts and techniques. Systems software engineering/programming is a specialized area of software engineering/programming focused on software that operates/controls computer hardware and provides a platform for running end user applications. Includes operating systems, device drivers, utilities, and software; development tools (e.g., assemblers, compilers, etc.). The Lead Systems Engineer works on problems of diverse scope and complexity ranging from moderate to substantial.
+ The Lead Virtualization Engineer is responsible for architecting, implementing, and maintaining enterprise-grade virtual environments that support the organization's critical applications and services. This role requires broad expertise in virtualization technologies, including but not limited to desktop and application virtualization, server virtualization, cloud-based virtual infrastructure, and remote access solutions. The Lead Engineer will guide technical teams, ensure optimal performance, security, and scalability of all virtualized resources.
**Key Responsibilities:**
+ Design, deploy, and manage complex virtual environments using industry-leading platforms (e.g., VMware, Hyper-V, Citrix, Microsoft Azure Virtual Desktop, and others).
+ Oversee the lifecycle management of virtual systems, including provisioning, patching, upgrading, and decommissioning.
+ Develop and maintain technical standards, procedures, and best practices for virtual infrastructure and remote access solutions.
+ Collaborate with cross-functional teams to assess business requirements and deliver scalable, secure, and resilient virtual solutions.
+ Lead troubleshooting and incident resolution efforts for virtual platforms, ensuring minimal disruption to business operations.
+ Conduct capacity planning, performance analysis, and optimization of virtual resources.
+ Mentor junior engineers and serve as a subject matter expert on virtualization technologies.
+ Ensure compliance with relevant security policies, regulatory requirements, and audit controls.
+ Research emerging trends and recommend adoption of new technologies to improve operational efficiency.
**Use your skills to make an impact**
**Required Qualifications**
+ **Our Department of Defense contract requires U.S. citizenship for this position.**
+ **Successfully receive approval for government security clearance (eQIP - electronic questionnaire for investigation processing). Employment with Humana Government Business is contingent upon your having access to government information and systems**
+ 7+ years of hands-on experience in virtualization engineering and infrastructure management.
+ Strong expertise in enterprise virtualization technologies (e.g., VMware vSphere/ESXi, Microsoft Hyper-V, Citrix Virtual Apps and Desktops, cloud virtualization platforms).
+ Solid understanding of networking, storage, and security concepts in virtual environments.
+ Excellent problem-solving, communication, and documentation skills.
+ Experience with Citrix NetScaler in the Gateway configuration and load balancing.
**Preferred Qualifications:**
+ Bachelor's degree in Computer Science, Information Technology, or related field;
+ Relevant certifications such as VCP, CCA, MCSE, or equivalent.
+ Experience with hybrid cloud or multi-cloud virtual infrastructure.
+ Familiarity with DevOps practices and Infrastructure as Code (IaC).
+ Proficiency with scripting and automation tools (e.g., PowerShell, Python, or similar).
**Additional Information**
This role will also provide support for Humana Government Business and will require a clear background investigation performed by the Defense Counterintelligence and Security Agency.
Location/Work Style: Remote US. Must be able to work Eastern Standard Time (EST) hours beginning at 9:00 A.M. EST.
**Why Humana**
Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security-both today and in the future, including:
+ Health benefits effective day 1
+ Paid time off, holidays, volunteer time and jury duty pay
+ 401(k) retirement savings plan with employer match once eligible
+ Tuition assistance
+ Scholarships for eligible dependents
+ Parental and caregiver leave
+ Employee charity matching program
+ Network Resource Groups (NRGs)
+ Career development opportunities
**Work-At-Home Requirements**
To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
+ At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
+ Satellite, cellular and microwave connection can be used only if approved by leadership.
+ Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
+ Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
**Social Security Task**
Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from ******************** with instructions on how to add the information into your official application on Humana's secure website.
**_*This is a remote position._**
**_**Must be able to work EST hours._**
\#LI-Remote
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$117,600 - $161,700 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 01-25-2026
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
Easy ApplyConsulting Analyst or Associate
Cambia Health Solutions job in Portland, OR
Consulting Research Associate I, II or Consulting Research Analyst
Work a Hybrid schedule 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 Consulting Research Associates and Analysts is living our mission to make health care easier and lives better. As a member of the Actuarial team, our Consulting Research Associates and Analysts provide consultation on the design, testing and enhancement of corporate programs. Achieves actionable insights and solutions using analytical and statistical methods, project management and business knowledge. Researches and evaluates programs and outcomes to determine performance against stated objectives. Documents and communicates recommendations and solutions to business partners - all in service of creating a person-focused health care experience.
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:
Consulting Research Associate I would have a BA/BS degree in social science, public health, economics, statistics, actuarial science or equivalent related field with less than 3 years of related work experience or equivalent combination of education and experience. Master's degree preferred.
Consulting Research Associate II would have a BA/BS degree in social science, public health, economics, statistics, actuarial science or equivalent related field and a minimum of 3 years of related work experience or equivalent combination of education and experience. Master's degree preferred.
Consulting Research Analyst would have a BA/BS degree in social science, public health, economics, statistics, actuarial science or equivalent related field and a minimum of 5 years of related work experience or equivalent combination of education and experience. Master's degree or PhD preferred.
Skills and Attributes:
Perform complex analyses on programs and initiatives and creates visual representations and summary reports of findings. Develops meaningful dashboards and presentations that use information to inform and influence business activities and strategies.
Applies knowledge of state and federal regulatory policies and procedures to program analysis and recommended actions.
Extract, sort, cleanse, aggregate and process data from multiple sources, developing queries and reports based on business requirements.
Work both independently and as part of a larger team supporting various internal customer groups on identifying business challenges and evaluating solutions to achieve objectives.
Collaborate with cross-functional teams to develop business cases, identify business problems and understand desired business outcomes.
Completes analysis and applies judgment to derive recommendations for complex challenges and initiatives.
Ensures the appropriate identification of root causes through effective use of data analysis tools and techniques.
Prepares and presents standard and ad-hoc analysis to business partners that help guide decisions and support results.
Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired
Additional General Functions & Outcomes for Consulting Research Analyst
Perform responsibilities above with an increased degree of independence and self-direction.
Provide higher level consultation on findings and recommendations.
Works and interacts across the organization with a variety of business units.
What You Will Do at Cambia:
Experience with analytical / statistical programming tools for data extraction and summarization, statistics, visualization and analysis (Alteryx, SAS, SQL, R, Tableau, etc.). Ability to develop and modify queries to extract large amounts of data for standard and ad-hoc data requests.
Experience with pre-processing of data, such as cleansing, aggregating, sorting, and combining data. Ability to combine multiple sources of data.
Experience or coursework in advanced analytics such as analytic discovery, descriptive statistics, forecasting, experimental design, statistical inference, or predictive models.
Ability to analyze and interpret complex quantitative and qualitative data, independently or as part of a team. Ability to synthesize analytic insights with business questions, literature, judgment, and policy knowledge to develop options, action plans, and solutions for internal business partners.
Excellent oral, written, and presentation skills to effectively interface and communicate with customers.
Demonstrated ability to facilitate or coordinate activities or projects, including the ability to identify business requirements, resolve issues, and build consensus among groups of diverse stakeholders.
Additional Minimum Requirements for Consulting Research Analyst
Deeper experience than Consulting Research Analyst Associate in analytical / statistical programming tools and in the ability to extract, summarize, and visualize data for requests. Demonstrated ability to thoroughly and accurately pre-process and combine multiple sources of data.
Demonstrated application of advanced analytic skills in one or more areas including analytic discovery, descriptive statistics, forecasting, multivariate modeling, experimental design, statistical inference, or predictive models.
Ability to provide analysis and data interpretation in support of strategy development, program implementation, and evaluation. Ability to develop and recommend innovative solutions by synthesizing literature, expert opinion, policy, and analytic insights.
Ability to serve as a Cambia resource for current programs and new opportunities by combining business knowledge with program evaluation concepts and methodologies.
Ability to present to and communicate with a broad array of internal and external customers, including leadership.
Ability to coordinate across teams or functions to drive solutions and to resolve issues in a timely and effective manner. Assists with training and staff development activities.
Applies knowledge of healthcare and interventions to improve member experience and achieve cost containment and other corporate objectives.
Designs, develops or oversees acceptance testing of new reports, programs, and models. Reviews reports and other deliverables with end customer in mind to ensure outputs meet expectations prior to being put into production.
The expected hiring range for a Consulting Research Associate I is $62,100.00 - $82,800.00 depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. The bonus target for this position is 10%. The current full salary range for this role is
$57,000.00 to $95,000.00.
The expected hiring range for a Consulting Research Associate II is $75,700.00 - $102,350.00 depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. The bonus target for this position is 10%. The current full salary range for this role is $71,000.00 to $116,000.00.
The expected hiring range for a Consulting Res Analyst is $91,800.00 - $123,100.00 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 $86,000.00 to $141,000.00.
#LI-hybrid
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 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 Privacy Policy.
Auto-ApplyProgram Director Accreditation and Delegation
Cambia Health job in Salem, OR
Hybrid in Renton, WA or Portland, OR 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 Program Directors are living our mission to make health care easier and lives better. As a member of the Health Care Services team, our Program Director Accreditation and Delegation plans, directs, and manages enterprise-wide quality management and improvement initiatives that drive clinical excellence and operational performance across the organization, while overseeing accreditation, delegation, and quality of care activities. This position provides strategic leadership to ensure operational and procedural compliance with regulatory requirements for Health Care Services. The Program Director serves as a senior leader representing the department in interactions with all levels of management, vendor partners, providers, government officials, accrediting agencies, and external consultants - all in service of making our members' health journey easier.
Do you thrive in roles where you influence strategy across an entire organization? Are you looking for a position where your decisions directly impact clinical excellence and member outcomes? Then this role may be the perfect fit.
What You Bring to Cambia:
Qualifications:
* Bachelor's degree in healthcare or a related field (Master's is preferred)
* 8 years of leadership experience
* 7 years of insurance industry experience or an equivalent combination of education and experience.
* A Certified Professional in Healthcare Quality (CPHQ) is preferred
Skills and Attributes:
* In-depth knowledge of managed care principles, health insurance industry trends and technology, with demonstrated application of regulatory and quality standards including Medicare, URAC, NCQA, and other accreditation requirements
* Extensive experience applying quality management and improvement methodologies (Lean, Six Sigma, PDSA cycles, evidence-based frameworks) with successful URAC or NCQA accreditation process experience
* Advanced competency in pulling, managing, organizing, and analyzing data to surface actionable insights
* Ability to write policies and procedures, develop monitoring/auditing tools, and use judgment and knowledge of standards to identify scenarios requiring delegation oversight
* Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired
* Proven ability to develop and lead teams across multiple locations or remote settings, including hiring, goal setting, coaching, and developing supervisors and employees while managing resources, budgets, and deliverables
* Strong verbal and written communication and presentation skills with ability to negotiate and resolve complex, sensitive issues diplomatically and persuasively across diverse internal and external contacts
* Strategic thinking capability to independently identify issues, opportunities, gaps, and effective solutions while collaborating cross-functionally to drive innovative initiatives and improve processes and results
* Advanced analytical skills to analyze complex situations, learn quickly, synthesize solutions and action plans, and use thorough business understanding to influence initiatives
What You Will Do at Cambia:
* Leads development and execution of compliance, quality, and delegation policies while designing and implementing division and corporate-level projects related to accreditation and delegation activities
* Establishes long-term departmental goals in conjunction with division leadership, maintains quality management frameworks that support continuous improvement culture, and drives best practice adoption across all business functions
* Communicates and interprets laws, regulatory procedures, and accreditation standards while ensuring legislative, regulatory, and accreditation changes are promptly identified and implemented across the organization
* Develops, maintains, and revises policies, procedures, and audit tools for oversight of delegated functions including credentialing, utilization management, case management, appeals, claims, and network management
* Conducts periodic oversight reviews of delegated entities, prepares final reports identifying deficiencies, develops corrective action plans with timelines, and escalates mandatory standard deficiencies while monitoring entity performance
* Champions quality improvement best practices by mentoring team members in QI methodologies (Lean, Six Sigma, PDSA cycles), fostering data-driven decision making, and leading projects that drive measurable organizational transformation
* Collaborates with leadership and cross-functional teams to identify improvement opportunities, serves as primary quality management subject matter expert providing guidance across departments, and facilitates knowledge sharing and best practice dissemination
* Develops and executes quality management strategies aligned with organizational goals, monitors quality trends, analyzes performance data, and recommends corrective actions to senior leadership while ensuring regulatory compliance and driving innovation
* Manages financial targets, department budget, and workforce allocation while overseeing project plans to ensure deliverables meet compliance and regulatory standards
* Defines business requirements for delegation-related reporting and data systems, manages design and control of delegation reporting systems, and tracks corrective action plans from internal monitoring and external audits
FTEs supervised
3-10
#LI-Hybrid
The expected hiring range for a Program Director is $134,300 - $181,700 depending 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 $126,000 - $206,000.
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 (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 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 Privacy Policy.
Auto-ApplyCentral Fill Pharmacy Technician
Beaverton, OR job
"A Day in the Life" video Opportunities with Genoa Healthcare. A career with Genoa Healthcare means you're part of a collaborative effort to serve behavioral health and addiction treatment communities. We do more than just provide medicine: we change lives for the better. People with serious mental or chronic illness - and those who care for them - have moving stories, and at Genoa we become their voice, their partner. Working as part of a coordinated care team, we partner with community-based providers and others to ensure that people with complex health conditions get the right medications and can follow their treatment plans. Our personalized services - in-clinic pharmacies, medication management and more - are leading the way to a new level of care.
Genoa is a pharmacy care services company that is part of Optum and UnitedHealth Group's family of businesses. We are part of a leading information and technology-enabled health services business dedicated to making the health system work better for everyone. Join us to start Caring. Connecting. Growing together.
We seek a Central Fill Pharmacy Technician to support all functions of the Genoa mental health and specialty pharmacy primarily through dispensing medical prescriptions and performing necessary clerical duties while under the direct supervision of a Registered Pharmacist.
Hours: Monday - Friday, 8:30am - 5pm PST
Location: 8700 SW NIMBUS AVE STE C BEAVERTON, OR 97008
Primary Responsibilities:
* Provide exceptional customer service to all consumers and members of the clinic staff
* Fills prescription orders and makes them available for verification under direct supervision of the Registered Pharmacist
* Orders, receives and stores incoming pharmacy supplies
* Receives and processes wholesaler medication orders
* Verifies medication stock and enters data in computer to maintain inventory records
* Works with the Pharmacist to assist in the pharmacy functions and keeping the pharmacy in compliance with all federal and state requirements
* Performs various clerical duties relating to the department
* Communicates with strong professional verbal and written communication skills
* Other duties as assigned
What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:
* Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
* Medical Plan options along with participation in a Health Spending Account or a Health Saving account
* Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
* 401(k) Savings Plan, Employee Stock Purchase Plan
* Education Reimbursement
* Employee Discounts
* Employee Assistance Program
* Employee Referral Bonus Program
* Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
* More information can be downloaded at: *************************
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
* Active and unrestricted Pharmacy Technician license in the state of Oregon or the ability to obtain within 60 days of hire
* Access to reliable transportation & valid US driver's license
Preferred Qualifications:
* National Pharmacy Technician Certification
* 6+ months of Pharmacy Technician experience
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $16.00 to $27.69 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
#RPO #RED
Care Navigator (Adult Population)
Salem, OR job
You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility.
**** This role prefers candidates to hold an active Oregon license as an Licensed Practical Nurse (LPN). Candidates are not required to live in Oregon but prefer them to be licensed in that state. ****
**Position Purpose:** Develops, assesses, and coordinates care management activities based on member needs to provide quality, cost-effective healthcare outcomes. Develops or contributes to the development of a personalized care plan/service plan for members and educates members and their families/caregivers on services and benefit options available to improve health care access and receive appropriate high-quality care through advocacy and care coordination.
+ Evaluates the needs of the member, barriers to care, the resources available, and recommends and facilitates the plan for the best outcome
+ Develops or contributes to the development of a personalized care plan/service ongoing care plans/service plans and works to identify providers, specialists, and/or community resources needed for care
+ Provides psychosocial and resource support to members/caregivers, and care managers to access local resources or services such as: employment, education, housing, food, participant direction, independent living, justice, foster care) based on service assessment and plans
+ Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure identified care or services are accessible to members in a timely manner
+ May monitor progress towards care plans/service plans goals and/or member status or change in condition, and collaborates with healthcare providers for care plan/service plan revision or address identified member needs, refer to care management for further evaluation as appropriate
+ Collects, documents, and maintains all member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators
+ May perform on-site visits to assess member's needs and collaborate with providers or resources, as appropriate
+ May provide education to care manager and/or members and their families/caregivers on procedures, healthcare provider instructions, care options, referrals, and healthcare benefits
+ Other duties or responsibilities as assigned by people leader to meet the member and/or business needs
+ Performs other duties as assigned.
+ Complies with all policies and standards.
**Education/Experience:** Requires a Bachelor's degree and 2 - 4 years of related experience. Requirement is Graduate from an Accredited School of Nursing if holding clinical licensure or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.
**License/Certification:**
+ Current Oregon clinical license preferred.
Pay Range: $22.50 - $38.02 per hour
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
Business Ops II
Cambia Health Solutions job in Portland, OR
Business Operations Specialist I or II
Work a Hybrid schedule 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 Business Operations Specialists is living our mission to make health care easier and lives better. As a member of the Actuarial Risk Adjustment team, you will contribute to the achievement of organizational goals at the team, department, or function level through the management of multiple (often changing) objectives that span multiple domain areas (ex., project management, program management, data analysis, process improvement, business process analysis, communications & change management, etc.). Business Operations Analysts are “utility players” with responsibilities that are not better described by a more focused job family (ex. Project Manager, Data Analyst, Business Analyst, Program Manager, etc.) - all in service of creating a person-focused health care experience.
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:
Business Operations Specialist would have a Bachelor's degree in Business Administration, Operations Research, Computer Science or related field and 3+ years of experience in business operations, data analysis, or a related field or equivalent combination of education and experience.
Business Operations Specialist II would have a Bachelor's degree in Business Administration, Operations Research, Computer Science or related field and 5+ years of experience in business operations, data analysis, or a related field or equivalent combination of education and experience.
Skills and Attributes:
Business Ops Specialist I
Advance analytical and problem-solving skills.
Proficiency in Microsoft Office, particularly Excel.
Demonstrated ability to effectively organize, plan, prioritize, and complete deliverables.
Broad organizational knowledge and business sense, and knowledge and understanding of health care operations and administration
Ability to communicate and present information effectively, verbally and in writing, with all levels.
Demonstrated ability to think critically and articulate complex ideas.
Demonstrated ability to facilitate or coordinate activities or projects, including the ability to identify business requirements, resolve issues, and build consensus among groups of diverse stakeholders
Ability to collaborate with team members and stakeholders to define, develop, and deliver analytics that meet the needs of the business to manage routine operations, identify tactical decisions, and inform strategic direction.
Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired
Additional Minimum Requirements for Business Ops Specialist II
Highly advance analytical and problem-solving skills.
Proficiency in data analysis tools, such as Excel, SQL, and Tableau.
Strong leadership and mentoring skills.
Ability to represent the division visibly in internal meetings as a leadership presence.
Well-developed business sense (finance, accounting, economics, risk management).
Proven ability to perform and manage difficult tasks and deliver results with short deadlines without management assistance.
Demonstrated curiosity to tackle hard business problems using data and analytics to develop meaningful, practical solutions.
Ability to analyze and measure the effectiveness of existing business processes and develop sustainable, repeatable and quantifiable improvements.
Proven ability to lead and manage cross-functional teams to ensure project objectives are obtained and delivered.
Ability to communicate and present complex data, analysis or findings to all levels, in a way that is clear and understandable and supports the overall business decisions and goals.
Strong facilitation and presentation skills, including the ability to resolve issues and build consensus among groups of diverse stakeholders.
Ability to work independently and plan, prioritize and manage multiple projects with varying deliverable timelines and time constraints.
Ability to negotiate and resolve project and team issues with diplomacy and persuasiveness.
What You Will Do at Cambia:
Specific functions and outcomes will vary based on organizational priorities, but in general, are expected to focus on the following in their roles:
Business Ops Specialist I
Analyze data to identify trends, opportunities, and challenges.
Develop and maintain dashboards, reports, and metrics to track key performance indicators (KPIs).
Collaborate with cross-functional teams to identify areas for process improvement and develop solutions.
Manage small-scale projects and operational initiatives.
Develop and maintain documentation of business processes and procedures.
Applies knowledge of how various departments within the corporation work together to make the company run effectively.
Documents business requirements and methods used to generate work output.
Be able to adapt quickly and successfully project manage ad hoc special assignments and initiatives as they may develop.
Additional General Functions and Outcomes for Business Ops Specialist II
Lead data analysis and reporting to identify trends, opportunities, and challenges.
Manage medium-scale projects and operational initiatives.
Mentor and guide junior analysts in their professional development.
Perform complex analyses on programs and initiatives and create visual representations and summary reports of findings. Develops meaningful dashboards and presentations that use information to inform and influence business activities and strategies.
Work both independently and as part of a larger team supporting various internal customer groups on identifying business challenges and evaluating solutions to achieve objectives
Assist leadership with problem identification and resolution, and program development by researching, assessing, and analyzing issues, and providing recommendations.
Partners closely with the IT group to ensure there is a business and technical alignment of the strategic roadmap and projects.
Explains complex processes and status updates in a manner that ensures understanding at all leadership levels within the organization.
Identifies critical project risks and issues and drives issue resolution; appropriately escalates issues to senior leadership or key stakeholders. Raises awareness regarding critical project dependencies and ensures that all requirements are communicated to relevant work streams and business partners.
Work Environment
Work primarily performed in an office environment.
May be required to work outside of normal hours
The expected hiring range for a Business Operations Specialist I is $75,700.00 - $102,350.00 depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. The bonus target for this position is 10%. The current full salary range for this role is $71,000.00 to $116,000.00.
The expected hiring range for a Business Operations Specialist II is $91,800.00 - $123,100.00 depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. The bonus target for this position is 10%. The current full salary range for this role is $86,000.00 to $141,000.00.
#LI-hybrid
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 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 Privacy Policy.
Auto-ApplySpeech Therapist
Salem, OR job
**Explore opportunities with [agency name],** a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of **Caring. Connecting. Growing together.**
As the Speech Therapist in Home Health is responsible for the assessment and evaluation of patient care needs related to treating speech and language disorders, and functional training in communication, swallowing, and cognitive impairments. Based on this assessment and evaluation, the Speech Therapist works to help determine a treatment plan, performs interventions aimed at improving and enhancing the patient's well-being, and evaluates the patient's progress.
**Primary Responsibilities:**
+ Provides services within the scope of practice as defined by the state laws governing the practice of speech therapy, in accordance with the plan of care, and in coordination with other members of the health care team
+ Evaluates the patient's level of function by applying diagnostic and prognostic functional ability tests. Assists the physician in the development of the therapy plan of care
+ Treats patients to communicate effectively by expressing thoughts according to the patient's condition using acceptable standards of practice
+ Observes, records, and reports to the supervising nurse and/or physician the patient's response to treatment and changes in the patient's condition
+ Instructs the patient, the family and/or caregiver and other members of the health care team in areas of speech therapy in which they can participate
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
**Required Qualifications:**
+ Licensed in Speech Therapy in the state of Oregon
+ Current CPR certification
+ Current driver's license, vehicle insurance, access to a dependable vehicle or public transportation
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $71,200 to $127,200 annually based on full-time employment. We comply with all minimum wage laws as applicable.
_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._
_UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._
_UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._