Quality Improvement CoordinatorHybrid role (three days per week in office) at our Salt Lake City, UT; Boise and Lewiston, ID; Fargo, ND; Portland and Medford, OR; Vancouver, Renton, and Burlington, WA; and Little Rock and Springdale, AR offices. Preference will be given to current employees and candidates who reside within a commutable distance of our Salt Lake City, Boise, Fargo, Lewiston, Little Rock, and Springdale offices or who are willing to relocate.
Every day, Cambia's dedicated team of Quality Improvement Coordinators is living our mission to make health care easier and lives better. In this role, you will turn Quality Assurance and external audit findings into measurable improvement initiatives across Claims, Membership, and Customer Service. You will partner with staff and leaders to strengthen processes, improve quality results, and support better member and provider experiences.
Do you enjoy finding the root cause behind quality trends? Can you turn data and audit findings into practical improvements while coordinating multiple projects and stakeholders? Then this role may be the perfect fit.
What You Bring to Cambia:Qualifications:- Bachelor's degree in business, health care, communications, or a related field, or equivalent work experience related to membership, customer service, claims processing, and the health care insurance industry.
- At least five years of experience in Claims, Membership, and/or Customer Service relevant to audit responsibilities, or an equivalent combination of education and experience.
- At least three years of related Quality Assurance, Quality Improvement, or Quality Management experience.
- Claims, Membership, Customer Service, or Multi-Service experience applicable to the position is preferred.
Skills and Attributes:- Thorough knowledge of applicable systems, reference manuals, and other operational resources, with a record of meeting established departmental performance standards.
- Ability to understand and apply statistical and mathematical concepts, including sampling methodology, trending, and root cause analysis; completion of formal quality training or familiarity with quality principles.
- Expert PC skills and proficiency with corporate software such as Microsoft Word, Excel, and Outlook.
- Experience with data access tools such as SQL and Microsoft Access.
- Experience with AI tools and technologies to enhance productivity and decision-making in professional settings is highly desired.
- Creative problem-solving and business or operational process-improvement experience is desired.
- Strong interpersonal and presentation skills, with the ability to communicate with staff at all levels and with both large and small groups; facilitation skills preferred.
- Ability to manage multiple projects and priorities, take initiative, meet deadlines, and build effective cross-functional working relationships.
What You Will Do at Cambia:- Analyze Quality Assurance and external audit results to identify defects, trends, root causes, and measurable opportunities for improvement.
- Develop, implement, and maintain quality improvement initiatives, plans, presentations, reports, and long-term goals in partnership with staff and management.
- Manage and facilitate quality improvement projects that strengthen Member Services processes, improve member and provider satisfaction, and increase business productivity.
- Monitor quality measures, prioritize projects that maximize return on investment, and report progress and accomplishments to Quality Assurance and Member Services management.
- Assess the scope and potential frequency or financial impact of processing errors, then recommend feasible corrective actions.
- Initiate and track system enhancements and upgrades that support quality, including coordination, testing, implementation, reporting, documentation, and training activities.
- Build strong working relationships across Member Services, Quality Assurance, Reporting, and Internal Audit, and participate in calibration meetings and quality summits as needed.
Pay ranges vary based on the candidate's work location. The expected hiring range depends on skills, experience, education, and training; relevant licensure or certifications; and performance history.
- National pay structure - applies to the Boise and Lewiston, ID; Salt Lake City, UT, Oregon and Washington. The full salary range is $66,000 to $108,000, and the bonus target is 8%. The expected hiring range is $69,500 to $95,500.
- Regional pay structure - applies to North Dakota and Arkansas, and Idaho and Utah locations outside the metro areas listed above: The full salary range is $59,000 to $98,000, and the bonus target is 8%. The expected hiring range is $66,850 to $86,350.
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.
