Risk Management BSA I, II, III

Risk Management – Business System Analyst I, II or III 

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.  

Who We Are Looking For: 

Every day, Cambia’s dedicated team of Business System Analysts (BSA) is living our mission to make health care easier and lives better. As a member of the Risk Management team, our BSAs are responsible for complying with CMS mandates to submit Enrollment, Medical Claim and Pharmacy Claims data for Reinsurance Reimbursement, Member Risk Assessment and Risk Corridor calculations – all in service of making our members’ health journeys easier.  

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. 

What You Bring to Cambia: 

Qualifications:  

The Risk Management BSA I:  Bachelor's degree in Business, Data Analysis or other related field plus 2 years’ experience with data analysis, process modeling or equivalent combination of education and experience.

The Risk Management BSA II:  Bachelor's degree in Business, Data Analysis or other related field plus 2 - 4 years’ experience with data analysis, process modeling or equivalent combination of education and experience. 

The Risk Management BSA III:  Bachelor's degree in Business, Data Analysis or other related field plus 5 - 7 years’ experience with data analysis, process modeling or equivalent combination of education and experience. 

Skills and Attributes: 

• Experience aggregating, reviewing and extracting data from various sources to create larger, more complex data sets.

• Good research and problem solving skills including the ability to determine action steps and remediation actions to resolve issues. 

• Ability to accurately complete activities within established deadlines. Ability to work under pressure and partner with others.

• Good written and verbal communication skills including the ability to work with internal and external partners. 

• Proficiency with Microsoft Office software programs and general experience database query tools. 

• Ability to update process documentation to ensure activities and outputs align with CMS guidelines.

• General knowledge of medical terminology and procedure coding.

Additional Requirements for BSA II:

• Ability to identify problems, develop solutions and implement actions with minimal supervision.

• Ability to develop and modify data queries for use in the CMS data submission process. Works with internal partners to test and validate the effectiveness of new or modified queries.

Additional Functions and Outcomes for BSA III:

• Tracks and monitors CMS data submission guidelines.  Reviews and verifies updates made to process documentation align with data submission guidelines.  Acts as a resources to others on the Risk Management team.

• Updates business partner groups (enrollment, medical claims, pharmacy claims, etc.) on annual changes to CMS submission requirement. 

What You Will Do at Cambia:  

• Extracts required information from the source systems into a staging area and performs validation checks based on CMS Edge Server Business Rules.

• Submits data to the Edge Server via an established translation process. 

• Reviews data validation reports that are received back from CMS and any errors are investigated and corrected prior to data being resubmitted.

• Communicates with internal/external customers to resolve any errors within the source systems for any of the above areas.

• Encourages ongoing innovation and looks for opportunities to enhance the quality and efficiency of departmental processes. 

• Assists in the training and communicating system changes for end-users and other affected staff.

• Schedules, organizes and prioritizes work to ensure timely completion of all assigned activities.

• Maintins process documentation and ensures data submission and validation activities align with CMS guidelines.

Additional Functions and Outcomes for BSA II:

• Partners with Risk Management leadership to prioritize data submission activities and resolve issues in a timely manner.   

• Creates new data queries for the data submission process.

Additional Functions and Outcomes for BSA III:

• Communicates to the enrollment, medical claims, pharmacy claims, and supplemental condition code business partners as to what the requirements are for CMS submission.

• Completes technical peer review of process improvements and ad hoc departmental projects.

Work Environment

• Work performed in office environment or can be remote.
• Travel rarely required, locally or out of state.
• May be required to work outside normal hours.

The expected hiring range for a Risk Management BSA I is $62,100.00 - $82,800.00 depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. The bonus target for this position is 5%.  The current full salary range for this role is $57,000.00 to $95,000.00.

The expected hiring range for a Risk Management BSA II is $68,900.00 - $93,150.00 depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. The bonus target for this position is 10%.  The current full salary range for this role is $64,000.00 to $106,000.00.

The expected hiring range for a Risk Management BSA III is $75,700.00 - $102,350.00 depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. The bonus target for this position is 10%.  The current full salary range for this role is $71,000.00 to $116,000.00.

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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.