Performance Integrity Analyst I, II, or III DOE

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.

Who We Are Looking For

Every day, Cambia’s dedicated team of Performance Integrity Analysts are living our mission to make health care easier and lives better. As a member of the Federal Employee Program (FEP) Services and Operations team, our Performance Integrity Analyst 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.

Ready to make a direct impact on federal employees' health care experience while building your analytical career at a mission-driven organization? Want to use your analytical skills to improve health care quality and accuracy for thousands of members while growing with an award-winning team? Then this role may be the perfect fit.

Qualifications

What You Bring to Cambia:

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

Skills and Attributes

• 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 highly desired.

Responsibilities

What You Will Do At Cambia:

• 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 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.

Pay

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.

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

Benefits

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.

Schedule

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.