The posting
Manager Utilization Management
Hybrid role (3 days/week in office) at our Salt Lake City, Boise, Fargo, Portland, Vancouver, Renton, Medford, Burlington, Lewiston, Little Rock and Springdale offices.
Preference will be given to current employees and candidates who reside within a commutable distance from our Salt Lake City, Boise, Fargo, Lewiston, Little Rock and Springdale offices or who are willing to relocate.
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 of Clinical Services leaders are living our mission to make health care easier and lives better. As a member of the Clinical Services leadership team, our Manager Operations Technical Services is responsible for executing and implementing the strategic plans and vision for the Operations Technical Services functions at Cambia. This position brings leadership in envisioning, planning and executing on the Operations division data and reporting needs. Oversees the development of reports, dashboards, extracts, data marts, small applications, and testing processes to support Operational activities; works across various business owners and IT areas to craft solutions to meet the division's data and information needs; manages a team of business/data analysts, and programmer analysts to deliver operational solutions and actionable business intelligence – all in service of creating a person-focused health care experience.
As a people leader, you are willing to learn and grow, understanding that leadership is a craft that is continuously honed as you support your team and the lives that depend upon us.
Are you excited to transform raw data into actionable insights that directly improve health care experiences for members across our communities? Would you thrive in a role where your strategic vision and technical leadership help shape the future of person-focused health care? Then this role may be the perfect fit.
What You Bring to Cambia:
Qualifications:
- Bachelor's degree in Computer Science, Mathematics, Business Administration, Engineering or a related field
- Minimum 10 years of related professional experience, including minimum 3 years of supervisory/leadership experience, or equivalent combination of appropriate education and experience
Skills and Attributes:
- Ability to develop and lead a team including: hiring, goal setting, coaching and development (including employees in multiple locations and remotely).
- Demonstrated competency in resource and project management: budgeting, organizing work, and providing leadership to staff, strategic planning, establishing measures for success, and managing to deliverables.
- Demonstrated understanding and domain expertise within Health Insurance Operational service area(s) to include Customer Service, Claims, Membership, and/or Provider Operations.
- Understands how data is used within business processes and its impact on desired business process outcomes and reporting. Gains awareness of the security, privacy and quality requirements for critical data entities and develops processes to optimize quality and value.
- Strong communication and facilitation skills with all levels of the organization, including the ability to resolve complex issues, build consensus among groups of diverse stakeholders, manage strategic partner relationships, and effectively lead and engage internal teams in the fulfillment of roles and responsibilities.
- Knowledge of health plan operations, health plan data sources and structures, and cost containment strategies.
- Demonstrated experience in business process re-engineering or process improvements is desirable.
- Must be able to effectively adapt to rapidly changing technologies and methodologies and apply them to technological and/or business needs.
- Ability to oversee definition and documentation of business requirements with non-technical, business personnel, and translation of those requirements into a technical solution.
- Ability to develop common solutions and acceptable compromises for business users with conflicting Business Intelligence needs.
- Experience in establishing specific deliverables for staff assigned to large scale, complex projects and work.
- Proven ability to motivate teams to achieve defined deliverables and be able to work effectively with internal and external customers.
- Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired
What You Will Do at Cambia:
- Handles all management responsibilities including performance reviews, employee development, hiring, coaching, and retention while establishing goals that align with Cambia Operations and holding direct reports accountable for results
- Provides strategic leadership and clear communication to Operations Technical Services teams across multiple locations, facilitating key meetings and organizing workload to ensure efficient, timely completion of assignments
- Leads planning and implementation of Operations technical services strategy by assembling teams, assigning responsibilities, identifying resources, and providing guidance to deliver high-quality, high-availability services
- Partners with Operations stakeholders to identify information needs, consolidate and automate ad-hoc data analysis, and develop reporting and data solutions that comply with all data privacy regulations and policies
- Oversees data services including architecture, transformation, stewardship, and end-user self-service while leading development of data controls for feeds and ETL processes to ensure data integrity and quality
- Collaborates across departments to resolve issues, manage support relationships between Operations teams, Operations BI, and vendors, and craft solution roadmaps for seamless access to information from various reporting, BI, and data discovery tools
- Stays current with medical management programs, cost containment strategies, medical technology, and market conditions while delivering solutions that include requirement analysis, system design, data models, program development, testing, and documentation
- As a member of our strong leadership community, you will provide direction to your team, engage them towards common goals and create a positive experience that helps people flourish.
FTEs Supervised
- 4 - 6
#LI-Hybrid
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.
National pay structure — applies to the Boise, Portland, Salem, Seattle/Renton/Tacoma, Burlington, Vancouver, Lewiston, and Salt Lake City metro areas: The expected hiring range is $122,400 - $165,600, the full salary range is $115,000 - $188,000 and the bonus target is 15%.
Regional pay structure — applies to North Dakota and to Idaho, Oregon, Washington, and Utah locations outside the metro areas listed above: The expected hiring range is $110,160 - $149,040, the full salary range is $103,000 - $169,000 and the bonus target is 15%.
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.
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.
We are an Equal Opportunity employer dedicated to a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required.
If you need accommodation for any part of the application process because of a medical condition or disability, please email [email protected]. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy.
