Integrity Analyst , II, or III DOE

Performance Integrity Analyst

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 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:

• 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, Blue Card, 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

• 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 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 $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.

• 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.

• 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.

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…