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Provider Contract Management Specialist

Work from home within Oregon, Washington, North Dakota, 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 Contract Managers are living our mission to make health care easier and lives better. As a member of the Network Operations team, our Provider Contract Management Specialists supports the accurate development, execution, and maintenance of healthcare provider contracts, including database management, regulatory filings, and audit support. This role also conducts research to resolve contract-related issues and provides training to internal teams on contract management systems and processes - all in service of creating an economically sustainable health care system.

Do you have a passion for system optimization and process improvement? Are you energized by sharing your expertise through mentoring and cross-functional collaboration? Then this role may be the perfect fit.

What You Bring to Cambia:

Qualifications:

• The Provider Contract Management Specialist would have a/an Bachelor's Degree in healthcare, business or related field and 3 years experience in the healthcare industry with a minimum of one year project-related experience, or equivalent combination of education and experience.

Skills and Attributes:

• Proficient in Microsoft Office and corporate software, with strong skills in grammar, formatting, and report preparation

• Action-oriented with the ability to organize, prioritize, and meet deadlines while producing accurate, detail-focused work

• Excellent oral and written communication skills for interfacing with internal and external contacts, including state regulatory bodies

• Strong teamwork and collaboration skills with peers, leadership, and cross-functional teams

• Proficient in contract management systems, including loading contract types, payment methodologies, document templates, and system reporting

• Skilled in contract filing software to manage regulatory compliance and state filing requirements accurately

• Familiarity with the Regence provider community, contracting protocols, reimbursement methodologies, and contract development processes desired

• Experience with AI tools and technologies to enhance productivity and decision-making highly desired

What You Will Do at Cambia:

• Prepares, configures, and maintains provider contract documents and templates in the contract management system, including technical coding, sub-coding, and system configuration to ensure accurate contract language, rates, and reporting capabilities

• Conducts peer reviews and system testing of documents, templates, and configurations prior to production deployment to minimize contractual, administrative, and regulatory risks

• Implements and coordinates provider contracts and reimbursement with Provider Operations, Provider Pricing, and Provider Enrollment staff, including annual fee schedule updates

• Works cross-functionally with Network Management, Legal, and Regulatory Compliance teams to draft, coordinate, file, and revise provider contracts in compliance with state Insurance Commissioner requirements

• Serves as the central point of contact for contract management system training, troubleshooting, and support, including developing training materials and conducting virtual sessions

• Maintains the integrity and accuracy of the provider contract database and repository, conducting ongoing audits and communicating updates to Network Management and other divisions

• Supports internal and external audits, triages claims and audit inquiries, processes Single Case Agreements, and assists with mass mailings across all Plans

• Develops and maintains contract policies, procedures, and desk references, enforces business requirements and standards, and assists with stakeholder coordination on contract language, operational standards, and data governance

Pay ranges vary based on the candidate's work location. The expected hiring range depends on skills, experience, education, and training; relevant licensure / certifications; and performance history.

Oregon, Washington, Utah, and Idaho:The expected hiring range is $30.30 - $31.50, the full salary range is$28.40 - $46.30 and the bonus target is10%.

North Dakota:The expected hiring range is$29.00 - $31.00, the full salary range is$26.03 - $41.60. #LI-remote

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.

As part of our security requirements, new hires will need access to a personal mobile device to set up Multi-Factor Authentication (MFA) upon joining the company. MFA is an important layer of protection for accessing Cambia systems and is required for all employees.