Program Manager or Sr DOE - Provider Incentives

Cambia Health Solutions; Portland (OR); On-site; USD 100,000 - 136,000; Full time

Job summary

A leading health solutions provider located in Portland, Oregon is seeking a Program Manager to manage complex healthcare programs aimed at improving member outcomes. The ideal candidate will have extensive experience in the healthcare industry, a strong background in project management, and advanced problem-solving skills. This role offers competitive compensation, generous benefits, and opportunities for career growth.

Benefits

Medical, dental, and vision coverage

Generous paid time off

401(k) plan with company match

Wellness programs

Qualifications

• Minimum 5 years of relevant experience in a large healthcare delivery or health insurance organization.
• Strong experience managing complex programs to achieve business objectives.
• Experience leading initiatives in a fast-paced environment.

Responsibilities

• Develop and drive strategic initiatives for Government Programs.
• Educate teams about Medicare and Quality Incentive Programs.
• Build relationships with providers to enhance member outcomes.

Skills

Project management

Communication

Problem-solving

Interpersonal skills

Healthcare knowledge

Education

Bachelor's degree in Nursing, Public Health, or related field

Tools

AI tools and technologies

Job description

**Build a career with purpose. Join our** **to create a person-focused and economically sustainable health care system.** Every day, Cambia’s dedicated team of Program Managers are living our mission to make health care easier and lives better. As a member of the Risk Adjustment and Stars team, our Program Managers partner with cross functional teams to develop, drive, and lead strategic initiatives to successfully meet Government Programs goals and objectives. Responsible for building trusting relationships between all stakeholders in provider incentive programs and Government Programs teams by understanding each team's vision, strategy and business objectives and establishing credibility as a trusted expert resource to influence positive outcomes – all in service of making our members’ health journeys easier.Are you Then this role may be the perfect fit.* Bachelor’s degree (Master's preferred) in Nursing, Public Health, Healthcare or Business Administration or related field* Minimum 5 years relevant experience in a population health in a large healthcare delivery, health insurance or health care consulting organization with specific Medicare/Government Programs or clinical/population health experience including demonstrated experience leading a program or equivalent combination of education.* Demonstrates extensive experience with Medicare, Quality, Stars and Risk Adjustment activities, including the ability to educate internal teams and providers on the importance of these activities to the success of Regence and provider organizations* Possesses strong experience in evaluating and managing multiple complex programs to ensure they achieve business objectives, with advanced knowledge of health insurance industry trends, Commercial and Federal Employee Program (FEP) legislation, regulations and exposure to integrated finance and delivery models as they relate to population health management and improving member health outcomes* Serves as the Government Programs subject matter expert and primary point of contact for all Quality Incentive Programs (QIP) stakeholders and for providers with more complex QIP and provider incentives issues and questions* Collaborates with teams that support Network Management with Medicare-specific data and education, while maintaining responsibility for Provider Incentive Program development, related metrics, and program operations* Acts as the liaison between QIP/provider incentives and Network Management to ensure transparency, effective communication and alignment, while maintaining general knowledge of value-based arrangements, including contract terms and performance targets* Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired* Exhibits advanced communication and facilitation skills with all levels both within and outside the organization, including the ability to identify problems, develop solutions, and implement chosen courses of action to resolve complex issues and build consensus while leading and motivating others through ambiguity in fast-paced environments* Demonstrates experience coordinating initiatives and bringing people together across multiple locations and functions while working across a highly matrixed organization, with advanced problem-solving skills and the ability to think about population health, clinical and business problems in new ways* Supports internal and external partners in developing strong working relationships with strategic providers to develop and/or support incentive/performance strategies that produce improved outcomes for members and enhance the member experience while providing mutual strategic benefit for the provider and Regence* Extensive experience with Medicare, Quality, Stars and Risk Adjustment activities, including the ability to educate internal teams and providers on the importance of these activities to the success of Regence and provider organizations* Strong experience in evaluating and managing multiple complex programs to ensure they achieve business objectives and deliver measurable outcomes* Advanced knowledge of health insurance industry trends, Commercial, FEP, and Medicare legislation, regulations, and exposure to integrated finance and delivery models as they relate to population health management and improving member health outcomes* Advanced communication and facilitation skills with all levels both within and outside the organization, including the ability to identify problems, develop solutions, and implement chosen courses of action to resolve complex issues and build consensus* Experience leading and motivating others by influencing and leading through ambiguity, with the ability to thrive in extremely fast-paced environments* Proven ability to coordinate initiatives and bring people together across multiple locations and functions while working effectively across highly matrixed organizations* Strong problem-solving skills with demonstrated ability to think about population health, clinical, and business problems in innovative ways and clarify key issues in complex situations* Expertise in developing and implementing strategic solutions that drive organizational success while managing competing priorities and stakeholder interestsThe expected hiring range for a Program Manager is $100,300 - $135,700 depending on skills, experience, education, and training; relevant licensure / certifications; and performance history. The bonus target for this position is 15%. The current full salary range for this role is $94,000 - $154,000.The expected hiring range for a Program Manager Sr is $110,500 - $149,500 depending on skills, experience, education, and training; relevant licensure / certifications; and performance history. The bonus target for this position is 15%. The current full salary range for this role is $104,000 - $169,000.* 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.* 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.Everyone is a health care consumer deserving of a simpler, more personalized experience. is transforming the health care system to revolve around people. For over 100 years we’ve designed people-first health solutions rooted in the nation’s first health plan, a loggers’ wage pool established in the Pacific Northwest. Today that pioneering spirit aligns our family of over 20 companies, including 4 not-for-profit serving over 3 million Americans.Cambia blends data science with a compassionate human perspective to anticipate people’s needs, and empower them to make smarter health care choices..### *Information about how Cambia Health Solutions collects, uses, and discloses information is available in our .*