Cambia Health Solutions
Remote Jobs
We are dedicated to making the health care experience simpler, better and more affordable for people and their families.
13 Jobs
Pharmacy Operations Coordinator
Cambia Health SolutionsWe are dedicated to making the health care experience simpler, better and more affordable for people and their families.
This role involves coordinating operational and cross-functional teams to deliver initiatives that optimize prior authorization (PA) operations through enhanced efficiency, regulatory compliance, training, and quality improvements. Demonstrate strong knowledge of clinical protoco...
Risk Adjustment Auditor II
Cambia Health SolutionsWe are dedicated to making the health care experience simpler, better and more affordable for people and their families.
This role involves performing retrospective and prospective chart reviews to ensure accurate risk adjustment reporting. Verifies and ensures the accuracy, completeness, specificity, and appropriateness of provider-reported diagnosis codes based on medical record documentation. Re...
Appeals Specialist I
Cambia Health SolutionsWe are dedicated to making the health care experience simpler, better and more affordable for people and their families.
This role involves managing all activities associated with requests for Provider Billing Disputes and Appeals. Analyze, prepare, and evaluate prior determinations Coordinate clinical review if needed Make decisions and provide notifications Follow guidelines outlined by contracts...
Pharmacy Services Technician
Cambia Health SolutionsWe are dedicated to making the health care experience simpler, better and more affordable for people and their families.
This role involves providing technical support for pharmacy benefit, reimbursement, and other drug use issues which do not require clinical judgment. The Pharmacy Services Technician assists the Clinical Pharmacy Consultants and Pharmacy Services staff with formulary-related oper...
Supervisor – Appeal Operations
Cambia Health SolutionsWe are dedicated to making the health care experience simpler, better and more affordable for people and their families.
Supervisor overseeing Appeals Operations team for health insurance claims processing
Supervisor of Appeal Operations
Cambia Health SolutionsWe are dedicated to making the health care experience simpler, better and more affordable for people and their families.
This role involves supervising the Appeal Operations team and acting as a resource for Certified Professional Coders and non-clinical support staff. Oversees and coordinates team activities to achieve business objectives. Ensures timely processing of member and provider claims in...
Provider Engagement Consultant
Cambia Health SolutionsWe are dedicated to making the health care experience simpler, better and more affordable for people and their families.
Engage and support provider relationships to improve performance and outcomes through meetings, data consolidation, reporting, presentations, and cross-functional initiatives. Manage workflows, documentation, and operational processes to drive provider engagement and performance improvements.
Program Manager or Sr DOE - Provider Incentives
Cambia Health SolutionsWe are dedicated to making the health care experience simpler, better and more affordable for people and their families.
The Program Manager will lead strategic initiatives for Government Programs in healthcare, manage complex programs, and foster relationships with stakeholders to drive successful outcomes in provider incentive programs.
Performance Integrity Analyst I
Cambia Health SolutionsWe are dedicated to making the health care experience simpler, better and more affordable for people and their families.
Performance Integrity Analyst auditing claims for a person-focused health care system
Stop Loss Producer Relations Administrator II
Cambia Health SolutionsWe are dedicated to making the health care experience simpler, better and more affordable for people and their families.
Stop Loss Producer Relations Administrator II responsible for producer relations activities
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