Performance Integrity Analyst I, II, or III DOE

About the Role

Build a career with purpose as a Performance Integrity Analyst on Cambia’s Federal Employee Program (FEP) Services and Operations team. You will examine and validate Plan and employee performance according to established policies, procedures, and mandated audit guidelines. Monitor accuracy and timeliness of claims, membership, and customer service to meet performance and service level goals. Provide reports, feedback, and recommendations for quality improvement to management—all in service of creating a person-focused health care experience.

Responsibilities

• Audit claims, enrollment, or customer service activities for accuracy and timeliness according to audit policies, procedures, and mandated guidelines.
• Encourage team and individual contributions toward the company's quality initiatives in improvement efforts.
• Participate in team efforts to develop or update department standards.
• Provide feedback on the department's performance in reaching service and performance level goals.
• Remain continuously current on changes and/or additions to all other applicable departments' policies, procedures, and guidelines.
• Thoroughly investigate problems.
• Identify and report inconsistencies or ambiguities in manuals, policies, and guidelines.
• Compile performance statistics and identify potential trends.
• Generate reports.
• Participate in testing implemented system changes.

Requirements

• Four years of experience in Claims, Membership, or Customer Service, depending on current business need, or an equivalent combination of education and job-related experience.
• Audit experience is desirable.

Skills

• Ability to understand and apply mathematical concepts.
• Demonstrated proficient PC skills and familiarity with corporate software, such as Word, Excel, and Outlook.
• Knowledge of claims coding, BlueCard, membership and customer service processes, applicable systems including pricing, and provider contract language.
• Experience with AI tools and technologies to enhance productivity and decision-making in professional settings is highly desired.

Pay

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

• Performance Integrity Analyst I
  • Oregon, Washington, Utah, and Idaho: Expected hiring range $20.50 - $30.80/hour; full salary range $19.20 - $34.90/hour; bonus target 5%.
  • North Dakota: Expected hiring range $22.46 - $30.83/hour; full salary range $20.32 - $32.51/hour.
• Performance Integrity Analyst II
  • Oregon, Washington, Utah, and Idaho: Expected hiring range $23.00 - $33.90/hour; full salary range $21.60 - $38.40/hour; bonus target 5%.
  • North Dakota: Expected hiring range $24.30 - $32.88/hour; full salary range $22.00 - $35.19/hour.
• Performance Integrity Analyst III
  • Oregon, Washington, Utah, and Idaho: Expected hiring range $25.90 - $37.30/hour; full salary range $24.40 - $42.20/hour; bonus target 5%.
  • North Dakota: Expected hiring range $26.42 - $35.74/hour; full salary range $23.91 - $38.25/hour.

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.

Schedule

This role offers work-from-home options for employees located in Oregon, Washington, Idaho, or Utah. To take advantage of this flexible option, employees must have:

• A wired internet connection that is not satellite or cellular.
• Internet service with a minimum upload speed of 5Mb and a minimum download speed of 10Mb.

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.

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.

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.