Cambia Health Solutions

Role Description The Medical Policy Research Analyst Intern will primarily identify, appraise, and summarize scientific literature and clinical practice guidelines for the development and implementation of medical policies to be used by Medical Directors, internal clinical staff, and external providers and members. Additionally, the Intern will gain insight into broader projects that may include work on systems for electronic authorizations of medical claims or other ongoing projects. The ideal candidate will have interest in learning about evidence-informed health policy and policy development. - Research, critically appraise, and summarize scientific literature and clinical practice guidelines to develop medical policy and clinical practice guidelines. - Document all research processes and medical policy decisions including literature searches, research summaries, and procedure code (CPT, HCPCS, etc) changes. - Present research and policy recommendations to the Medical Policy Workgroup for approval. - Collaborate and communicate across teams to ensure successful medical policy implementation and maintenance processes are completed. - Participate in Medical Policy team meetings and issue forums. - Additional team duties or projects as assigned or relevant to interests. Qualifications - Must be currently enrolled in a graduate degree program in Public Health, epidemiology, biostatistics, or other closely related field. - Familiarity with anatomy and physiology/disease processes; clinical research methods; medical terminology; and interpretation and application of medical policies. - Knowledge of techniques for conducting literature searches, analyzing and interpreting scientific medical literature for quality of study design and reliability of data. - Familiarity with factors that go into clinical decision-making (evidence, practice guidelines, etc). - Ability to work in a team environment along with the self-motivation to work independently. - Excellent written and verbal communications skills. - Strong organization, time management, problem resolution, and analytical skills. - Strong attention to detail with the ability to identify problems and recommend actionable solutions. - Experience with Microsoft Office applications (e.g. Excel, Word, PowerPoint) and ability to learn new technology quickly and effectively. - Must have a minimum of a 3.0 cumulative grade point average in the current program. Requirements - The expected hiring range for an intern is $22.00 – $27.00 per hour depending on skills, experience, education, and training. Benefits - 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. - Work from home options available for most roles, requiring a wired internet connection with a minimum upload speed of 5Mb and a minimum download speed of 10 Mb. Company Description 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.

Role Description The Assistant Director, Broker Strategy & Performance Management will oversee a team focused on maximizing value through broker distribution channels, managing compensation programs, and driving broker engagement and performance. The position sits within the Commercial Market Excellence organization, collaborating closely with Line of Business leaders, market sales teams, and key organizational partners – all in service of making our members’ health journeys easier. As a people leader, you are willing to learn and grow, understanding that leadership is a craft that is continuously honed as you support your team and the lives that depend upon us. Do you have a passion for optimizing distribution strategies and driving measurable results through broker partnerships? Do you thrive in a collaborative environment where you can lead high-performing teams and influence key business outcomes? Then this role may be the perfect fit. Qualifications - Bachelor's degree in Business, Marketing, Finance or related field - 7+ years of experience in broker management, distribution strategy or related field - 3+ years of people management experience - Strong understanding of broker compensation models and distribution channel economics - Proven track record of driving performance improvement through strategic initiatives - Excellent analytical skills with the ability to translate data into actionable insights - Outstanding communication and relationship-building skills - Experience leading and developing high-performing teams - Ability to collaborate effectively with cross-functional partners and Line of Business leaders - Strategic mindset with a focus on maximizing value through distribution channels Requirements - Lead and develop a high-performing team responsible for broker channel optimization and performance management - Drive strategic initiatives to ensure distribution channel investments deliver proportionate value and ROI - Design, implement, and optimize broker compensation programs and structures in partnership with technical, operations, and finance partners - Establish performance metrics, KPIs, and reporting frameworks to measure broker effectiveness and provide regular insights to senior leadership - Partner with Line of Business leaders, market sales teams, and key stakeholders to align broker strategies with organizational objectives - Leverage data analytics to identify trends, opportunities, and areas for optimization while ensuring competitive positioning and compliance - Serve as the primary point of contact for market and sales leaders to align distribution efforts with respective strategies - Identify, scale, and execute best practices through engagement and performance management initiatives Benefits - 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

Role Description The Stop Loss Underwriting Specialist supports the Stop Loss Underwriting team through data entry, running, and reviewing claims reports. This role is responsible for: - Completing contracts and fee schedules. - Handling all administration of contracts and fee schedules. - Completing travel and expenses for the stop loss director and team when applicable. - Providing other administrative support as directed. Do you thrive as a part of a collaborative, caring team? Then this role may be the perfect fit. Qualifications - High School diploma or GED. - 4 years office, data entry, or equivalent combination of education and experience, preferably in a health care environment. - Knowledge of stop loss claims processing preferred. - Demonstrated ability to exercise sound judgment, initiative, and discretion in a mature, sensitive, and confidential manner. - Proven attention to detail and accuracy in data entry and other administrative tasks. - Computer skills including experience using Microsoft Office (Word, Excel, Outlook) or comparable software. - Ability to learn and use complex systems. - Ability to organize, prioritize, and manage multiple tasks with little supervision. - Demonstrated ability to establish effective working relationships with coworkers and customers. - Ability to communicate effectively both orally and in writing. - Knowledge of medical terminology, insurance billing, and claims coding. - Demonstrated strong problem-solving skills and ability to investigate and resolve complex issues. - Demonstrated ability to consistently meet productivity and quality standards with minimal support. - Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired. Requirements - Perform data input for all new stop loss cases and/or claims. - Enter all required fields to generate explanation of benefit forms and/or Stop Loss contracts and apply the appropriate fee schedule. - Run reports, review and analyze data, and identify any areas of concern. - Run data downloads and reporting. - Review data and prepare management reports. - Understand Stop-Loss policy language and terms. - May assist with travel and completing expense reports. Benefits - 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.

Role Description Work from home within Oregon, Washington, Idaho or Utah. Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system. Every day, Cambia’s dedicated team of Clinical Pharmacist Consultants are living our mission to make health care easier and lives better. As a member of the Pharmacy Services team, our Clinical Pharmacist Consultant provides professional and clinical pharmacy expertise in making or guiding clinical decisions based on best practices by applying evidence-based medicine evaluations to determine the best quality medication choices that represent the best value in efficacy, safety and affordability. This may include: - Providing coverage recommendations for medications subject to prior authorization, appeals, retrospective claim reviews, and audits based on applicable medication coverage policies, member benefit contracts, and provider contracts. - Serving as a resource for other staff, such as medical directors or case managers, regarding clinical, policy and benefit questions and interventions. - Providing direct outreach to members and providers around current and future clinical programs that would benefit them. - Assisting in planning, developing, and implementing clinical strategies with respect to formulary management, drug utilization management, medication therapy management programs, quality initiatives, gaps in care, peer to peer conversations and drug information and education. - Analyzing health care cost information, development of position papers, medication coverage policies, formulary monographs and class reviews, cross-functional projects, and/or initiatives related to the provision of pharmacy benefits that impact safety, quality and affordability. Are you a pharmacist who wants your clinical expertise to impact thousands of lives — not just the patients in front of you? Do you find yourself wanting more than a traditional pharmacy role — craving the opportunity to shape formulary strategy, influence coverage policy, and drive real change in how people access the medications they need? Then this role may be the perfect fit. Qualifications - Bachelor's degree in Pharmacy or Doctor of Pharmacy (PharmD) or related field. - 3-5 years of experience in clinical acute care/hospital setting or equivalent combination of education and experience. - Pharmacy license. Successful completion of a pharmacy residency or advanced degree in health-related field preferred. - Must be an active and unrestricted licensed pharmacist in state of practice. Requirements - Clinical pharmacy background with ability to demonstrate clinical therapy skills and knowledge in a clinical care setting. - Demonstrated success in managing professional relationships in a managed care system, medical group, hospital, or related organizations. - Excellent verbal and written communication skills; strong business analytical skills and abilities; strong project management and coordination ability. - Knowledge of pharmaceutical products, including orals, injectables, infusion products, and chemotherapy; state and federal laws and rules regarding the practice of pharmacy and regulation of health care industry practices, such as DOLI, PPACA and HIPAA. - Strong knowledge of health care economics and financing; health care/pharmaceutical industry dynamics; and pharmacy/provider service reimbursement of medications. - Knowledge of Health Plan and benefit design structures and application; Medicare/CMS regulations and applicability in administering the Medicare Product; health care coding and payment systems (such as ICD-9, CPT, HCPCS, NDC). - Strong knowledge of compliance related activities, legislative and regulatory activities, health insurance operations, and legal issues. - Ability to collaborate as part of cross functional teams, to improve clinical programs, enhance processes and share clinical information. - Ability to work independently, to prioritize work, meet deadlines and achieve operational goals. - Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired. Benefits - 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.

Role Description Work a Remote 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. Every day, Cambia’s dedicated team of Temporary Payables Lead is living our mission to make health care easier and lives better. As a member of the Payables team, our Temporary Payables Lead is responsible for: - Assigning and monitoring the production of Payables Accountants while ensuring timely and accurate payments. - Representing the Payables function as the system subject matter expert ensuring that business requirements are tested, implemented, and maintained. - Supporting unclaimed property, corporate credit card, Tax Admin, and EFT Coordinator Functions. 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. Qualifications - Associate's degree with five years of progressively responsible experience in finance operations with emphasis within disbursements and/or commissions systems or an equivalent combination of education and related experience. - Strong leadership skills in overseeing a large diverse team. - Demonstrated ability to utilize critical thinking to respond to and resolve complex situations. - Strong interpersonal skills, self-motivation, excellent communication, a customer service orientation, tolerance for ambiguity, demonstrated sound decision making, exercise good judgment in confidential matters, and demonstrated analytical skills. - Ability to create queries that assist with in-depth analysis of data and advanced problem solving in order to correct errors that may result in payment issues. - Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired. Requirements - Serves as backup to the Manager, with the ability to make timely/accurate decisions as needed. - Supports management in the review and approval of high-level data flows and functional specifications. - Maintains department metrics and stats; works with the staff to ensure the established SLA's are achieved. - Conducts periodic quality assurance reviews of staff data entry to ensure all data and descriptions are entered accurately in the appropriate system. - Responsible for ensuring all daily processing batches are approved/posted for nightly batch match. - Responsible for the maintenance and continuous oversight of departmental desk policies and procedures. - Recommends new procedures and implementation strategies as necessary or indicated. - Ensures all changes are communicated to staff. - Oversees user maintenance of applicable system; works with various internal departments to solve system issues as necessary. - Leads the department's Year End activities including 1099 completion and accrual process. - Works closely with Manager and Financial Accounting and Reporting (FAR) during monthly and annual closing process ensuring online system has closed, vouchers have posted, interface edit rejects are corrected, and general ledger interface is posted correctly. - Responsible for oversight of manual check processing and uploading into systems. - On a monthly basis analyze and prioritize department workload and establish goals to maintain current stats. - Assists management in improving performance by establishing department goals, identifying and evaluating trends, and developing appropriate courses of action as needed. - Represents department as a member of company-wide teams and work groups. - Works directly with executives at times and is single point of contact for Direct Health Solutions Businesses. - Responsible for follow up with the staff on policies and daily processing issues. - Makes production decisions regarding outstanding issues that need immediate resolution. - Evaluates daily workflow and determines if processing adjustments need to be made to ensure timely processing of all work. - Responsible for gathering business requirements and creating documentation of system configuration, data flow, and business process changes. - Oversees the coordination of testing and works closely with business partners to implement solutions. - Participates in system enhancements, development, coordination, testing, and implementation of upgrades and new technologies. - Directs staff and participates in creating and maintaining User Acceptance Testing (UAT) Cases used for system changes. - Has oversight of Sales and Use tax process, reviews and approves quarterly filings, gives guidance as needed to ensure timeliness and accuracy in processing. - Directs new employee training and works with department management to develop ongoing training opportunities and programs. - Identifies training needs and reinforces learning through coaching. Benefits - The current full hourly range for this temporary role is $40.00 to $50.00 per hour depending on skills, experience, education, and training; relevant licensure/certifications; performance history; and work location. Company Description 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. - 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.

Role Description Temporary remote opportunity available to candidates in WA, ID, OR, and UT. This position has the potential to become a Cambia Full-Time position (FTE). This is NOT a commitment or guarantee of full-time employment with Cambia. Starting pay range $19.00 - $22.25/hour depending on experience and location. HR will reach out and provide specific information. This is a non-benefited role. Upcoming start dates include: - June 15th, 2026 - June 22nd, 2026 - June 29th, 2026 Your start date will be assigned based on class availability and the date of your application. If you are selected for an interview, please let HR know as soon as possible if any of the start dates listed above will not work for you. Every day, Cambia’s dedicated team of Customer Service Professionals (CSPs) are living our mission to make health care easier and lives better. As the face of Cambia, our CSPs play multiple roles – listener, problem-solver, investigator, and advocate – all in service of making our members’ health journeys easier and days brighter. As a CSP, you’ll act as the bridge between Cambia and those we serve, including members, providers, and other health care professionals. You’ll answer incoming calls on recorded lines, providing guidance and resources on benefits, claims, and eligibility. You’ll advocate for our members, track down answers to tricky questions, and ask for support when you’re stuck. In exchange for your excellent customer care, we provide competitive pay, career growth opportunities, a generous benefits package, and flexible and remote options to help you balance priorities in and outside of work. Qualifications - High school diploma or equivalent - 6 months of customer service call center experience; or - 6 months of customer service experience in insurance, retail, banking, hospital, medical office, or similar industry with extensive customer contact; or - Equivalent combination of education and experience - Proficient PC skills and an ability to navigate multiple applications while on calls - Ability to apply mathematical concepts and calculations Requirements - Excellent multitasking skills under pressure - Resilience, patience, and a positive attitude in the face of challenges - Clear, concise, and empathetic demeanor while responding to inquiries and requests - Proactive problem-solving skills and a knack for asking insightful questions to clarify callers’ needs - Sound decision-making and flexibility in a fast-paced environment - Willing to learn and adapt to changes in products and regulations and integrate feedback to improve skills and capabilities - Equally comfortable collaborating with a team and working independently - Ability to handle sensitive and confidential information with discretion - Preferred: knowledge of medical terminology and coding - Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired Benefits - Competitive pay - Career growth opportunities - Flexible and remote options Company Description 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.

Role Description Join Cambia's Internal Audit team for a comprehensive internship experience that spans both internal audit and financial controls. This position offers exposure to corporate systems auditing, compliance assessment, and internal controls over financial reporting. You'll work alongside experienced professionals to evaluate business operations, assess risk management practices, and support the organization's commitment to operational excellence and regulatory compliance. Qualifications - Minimum of two years of university education working towards an undergraduate or graduate degree in Accounting, Finance, Business Information Systems, Business, or related field - Candidates who have completed their degree in the last six months are preferred - Candidates who expect to complete their degree in the next nine months are preferred - Completion of the Intermediate Accounting sequence or its equivalent strongly preferred - Possess a minimum 3.0 cumulative undergraduate grade point average - Strong analytical and problem-solving skills with an interest in risk management, auditing, and information technology - Excellent oral and written communication skills - Demonstrated ability to organize, plan, prioritize, and complete complex assignments - Intermediate to advanced knowledge of Microsoft Word and Excel (required); experience with Microsoft Visio, PowerPoint, and Access (preferred) - Prior experience using data analytics tools (a plus) and prior experience with IT development projects (a plus) - Demonstrated experience working in a collaborative, team-oriented environment - Self-driven and independent, capable of working on projects with clear direction while not requiring daily supervision Requirements - Gather, collect, and assemble data from disparate sources - Perform research on industry best practices, organizational issues, policies/procedures, and business applications - Survey audit areas and recommend direction and objectives for proposed audits - Document processes and outcomes of research and investigation - Assist in planning, coordination, and execution of audits of corporate systems, processes, and operations - Perform audit activities following audit standards and in accordance with approved audit plans - Support the internal control evaluation lifecycle, including the annual assessment of internal controls over financial reporting - Evaluate application and management control systems - Analyze the efficiency and effectiveness of business operations - Review and test compliance with internal and external rules, laws, and regulations - Implement tests of financial, application, and entity-level controls - Document key business processes in partnership with process owners and subject matter experts - Document audit work and support the basis for audit conclusions and recommendations - Identify opportunities to improve operations and application controls and recommend solutions - Prepare reports documenting findings and conclusions - Participate in pre-audit and progress meetings with Cambia staff - Present results of work verbally and in writing - Participate in executive lunches, community service projects, and industry/leadership training - Interact with leaders at all levels of the organization Benefits - The base pay for this role is $25.00 an hour Company Description 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.

Role Description Every day, Cambia's dedicated Integration team is living our mission to make health care easier and lives better. As a member of the Integration Management Office, our Integration Managers lead the planning and execution of complex business integrations — coordinating cross-functional teams, driving strategic roadmaps, and delivering measurable business outcomes — all in service of creating an economically sustainable health care system. Do you thrive in fast-paced, ambiguous environments where no two deals are the same? Do you have a passion for bringing order to complexity and delivering results that matter? Then this role may be the perfect fit. Qualifications - Bachelor's degree in Business Administration, Finance, or related field required; MBA or MHA preferred - 10+ years of professional experience in consulting, corporate development, or integration management - 5–7 years of direct, end-to-end integration leadership experience across multiple functions (technology, operations, finance, HR), or an equivalent combination of education and experience - Experience with various deal types (acquisitions, divestitures, joint ventures) preferred - Healthcare industry experience strongly preferred - PMP, Change Management, or similar certification preferred Requirements - Proven ability to manage complex, multi-stakeholder projects with competing priorities - Strong executive presence with excellent written and verbal communication skills, including experience presenting to C-suite audiences - Demonstrated ability to influence senior leaders without direct authority in a matrixed organization - Strong analytical and problem-solving skills with keen attention to detail - Proven track record of successful integration delivery with measurable business outcomes - Ability to navigate ambiguity and drive results in dynamic, fast-changing environments - Experience building collaborative relationships and leading high-performing cross-functional teams - Knowledge of healthcare or health insurance industry preferred Benefits - 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

Portland, OR Telecommuting allowed from anywhere within ID, WA, OR, or UT Full time R-6491 Job Title: Software Quality Engineer III (multiple positions) Job Duties: The senior level engineer applies extensive technical knowledge and experience to develop and deliver solutions for software projects. Program, debug, and test applications in a development environment. Perform database design and system testing. Ensure the delivery of high-quality products and software services. Work with teammates to prevent and detect defects throughout the product lifecycle, evaluate the appropriateness of software solutions for customers and the enterprise, and enable delivery team productivity. Apply a wide variety for testing and quality assurance techniques to complex software projects often requiring coordination with multiple software delivery teams. Participate in a project scrum team and defect triage team. Manage personal work backlog using agile practices. Review user stories, acceptance criteria, specifications, software designs, code and tests and write automated and manual test cases and procedures. Collaborate with peers to ensure adequate test coverage and efficient test execution. Apply industry-standard methods to develop, automate and execute unit, component and system-level tests. Report test results, submit defects and verify defect fixes. Ensure software testability, test coverage and test maintainability meet project requirements. Assess the impact of requirements, design and code changes, recommend test updates and regression testing, and execute agreed upon tests. Act on metrics to improve process effectiveness, test execution, and product quality. Participate in process improvement efforts. Mentor team members to ensure software testability, achieve required test coverage and improve automated test stability and maintainability. Collaborate with Development to define software requirements, design and implementation to ensure testability, scalability, maintainability, and reliability. Develop new technical solutions to ensure project quality, cost and schedule requirements are met, risks mitigated, and quality plans and test plan are executable. Use metrics to understand process effectiveness, quality assurance and testing progress, and product quality and recommend actions. Lead assigned process improvement efforts. Assess vendor quality and testing based on requirements in Statements of Work. Collaborate with vendors to plan and execute integration and system level tests. Assess and escalate issues as needed to Software Quality Lead. Participate in defect triage, program risk analysis and development cycle-time optimizations. Identify opportunities to enhance test automation framework and tests. Travel required 1 to 2 times annually to any state Cambia does business, currently WA, OR, ID, and UT. Telecommuting from any state where Cambia does business (currently WA, OR, ID, and UT) is allowed. Job Requirements: Bachelor’s degree in Computer Science, Electronic/Electrical Engineering, Engineering, or related field or the foreign degree equivalent and 6 years of progressive, post-baccalaureate experience performing software quality and testing throughout product development, deployment and maintenance, including 3 years of experience in each of the following: - Writing, running, and automating tests. - Working with Java or C# programming languages. - Communicating with technical and non-technical project team members. - Working with web, mobile, database application technologies, and automated testing and tools. - Experience with one or more of the following: software reliability, automated test maintenance, static analysis, or code coverage. - Applying appropriate industry-standard processes and practices to prevent and detect defects throughout the software development lifecycle. - Utilizing metrics and understanding processes related to effective quality assurance and testing progress. - Working with web, mobile and database application technologies, automated testing, frameworks and tools. - Working with TDD/ATDD, Continuous Integration, Design for Testability, and Software Stability. - Selecting the appropriate industry-standard processes and practices to prevent and detect defects throughout the software development lifecycle. - Working across project teams to leverage existing knowledge, technologies and solutions. - Working with the Trizetto Facets database, integration points and table structure. - Working with ITS policies and system requirements determined by the BlueCross BlueShield Association. - Testing API’s using tools such as ThunderClient, Ready API, SoapUI or Jmeter. Experience may be gained concurrently. *The employer will also accept a Master’s degree in Computer Science, Electronic/Electrical Engineering, Engineering, or related field or the foreign degree equivalent and 4 years of experience performing software quality and testing throughout product development, deployment and maintenance including 3 years of experience in each of the requirements listed above. If you are a current tobacco/nicotine user, you are not eligible for employment with Cambia Health Solutions, Inc. This position qualifies for the company’s employee incentive referral program. #LI-DNI #IND123 #DNPBB The current salary range for this role is $138,320 - $142,000 per year. 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 CambiaCareers@cambiahealth.com. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy.

Title: Provider Contracting Executive or Senior, DOE Location: Renton, Burlington, Spokane or Tacoma, Washington Work Type: Hybrid, Full Time Job ID: 6245 Job Description: 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 Contracting Executives are living our mission to make health care easier and lives better. As a member of the Provider Contracting team, our Provider Contracting Executives lead the development and management of strategic contracting relationships with top-tier physicians, groups, institutions, and ancillary providers. Drive business growth through innovative products and reimbursement methodologies, while cultivating and maintaining key relationships and overseeing complex contract negotiations and administration - all in service creating a person-focused health care experience. Do you have a passion for serving others and driving business growth? 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 Provider Contracting Executive would have a Bachelor's Degree in healthcare, business or a related field and 5 years' experience in a healthcare industry provider contracting, relations, or analytical capacity or equivalent combination of education and experience. - The Provider Contracting Executive Senior would have a Bachelor's Degree in healthcare, business or a related field and 7 years' experience in a healthcare industry provider contracting, relations or analytical capacity or equivalent combination of education and experience. Skills and Attributes: - Strong industry knowledge: Strong understanding of managed care and accountable health system models, and their relationship to contracting strategy and reimbursement methodology. - Negotiation and relationship-building skills: Proven ability to build positive relationships and negotiate successfully with institutional, professional, and ancillary providers. - Payment methodology expertise: Demonstrated competency in varying payment methodologies, including Pay for Quality/Performance, DRG, APC, ASC, Capitation, Fee for Service, RBRVS, Per Diem, and Per Case. - Strong understanding of value-based programs and contracting models. - Proficiency and comfort in negotiating complex contract language. - Data analysis and strategy development: Ability to analyze financial, quality, and utilization data to develop contracting strategies and manage a portfolio of contracts. - High-pressure environment skills: Ability to work effectively in high-pressure circumstances, managing conflict and ambiguity. - Senior-level negotiation and communication skills: Proficiency in building relationships and negotiating successfully with large, complex, and market-leading institutional and professional providers, and ability to independently and effectively communicate with high-level executives internally and externally. - Leadership and portfolio management: Ability to oversee and manage a portfolio of contracts and provide leadership and guidance to others in the organization. - Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired What You Will Do at Cambia: - Maintains and expands the health care delivery system network by negotiating contracts and maintaining relationships with providers, positioning the organization to meet its objectives relating to cost effectiveness, quality of care, enrollment growth, administrative efficiency, product positioning, and profitability. - Monitors financial and utilization performance of contracts, develops plans to improve performance, and meets with key provider leaders to review reports, prepare analysis, and recommend strategies. - Develops and maintains new regional networks to support the introduction of new products, understanding health plan market pricing and communicating strategic benefits to providers. - Collaborates with provider consultants and representatives to ensure contracts are administered appropriately and improvement plans are managed. - Develops and manages risk arrangements, including pricing and accountable health system funding arrangements, and leads plan initiatives/pilots focused on provider network configuration, reimbursement, and management. - Develop long and short-range contracting strategies for each delivery system assigned, with a focus on reducing healthcare expenditures while delivering high-quality care to members. - Serves as a mentor to Provider Contracting Executives and others within the department, providing resources and guidance to support the organization's objectives. The expected hiring range for a Provider Contracting Executive is $83,300 - $112,700 for a Provider Contracting Executive Senior is $100,300 - $135,700 depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. The bonus target for the Provider Contracting Executive position is 10%. The bonus target for the Provider Contracting Executive Senior position is 15%. The current full salary range for the Provider Contracting Executive role is $78,000 - $128,000 and the Provider Contracting Executive Senior is $94,000 - $154,000. #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