Encounter Data Management Lead

Position Overview

• Location Type: Remote (with occasional travel)
• Job Type: Full-time
• Salary: $94,900 - $130,500 per year

The Encounter Data Management Lead develops business processes to ensure successful submission and reconciliation of encounter submissions to Medicaid. This role ensures encounter submissions meet or exceed all compliance standards through data analysis and develops tools to enhance the encounter acceptance rate by Medicaid, focusing on long-term improvements. The Lead advises executives on functional strategies and exercises independent judgment on complex issues with minimal supervision. This position is responsible for ensuring data integrity for claims errors and works on problems of diverse scope and complexity.

Location Requirement

• Candidates must be currently residing in Louisiana.

Required Qualifications

• 2 or more years of experience with encounter data submissions or related Medicaid experience.
• 2 or more years of project leadership experience.
• Prior demonstrated experience with process improvements.
• Ability to manage multiple tasks and deadlines with attention to detail.
• Excellent communication skills.
• Ability to operate under tight deadlines.
• Demonstrated problem-solving skills; ability to give direction and make sound business decisions.
• Proven organizational and prioritization skills and ability to collaborate with multiple departments.
• Ability to deliver presentations to senior leadership.
• Comprehensive knowledge of all Microsoft Office applications, including Word, PowerPoint, Outlook, and Excel.
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences.

Preferred Qualifications

• Master's Degree in Business Administration or a related field.
• Certification in Six Sigma or Project Management.
• Prior leadership experience over direct reports.
• Prior experience in a healthcare or insurance setting.

Work-At-Home Requirements

• Must have the ability to provide a high-speed DSL or cable modem for a home office.
• A minimum speed of 25Mbps download x 10Mbps upload is required.
• Satellite and Wireless Internet service are NOT allowed.
• A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information is required.
• Associates or contractors residing and working from home in California will be provided payment for their internet expense.

Interview Format

• The hiring process utilizes HireVue, a third-party vendor, for interviews.
• Selected candidates may be invited to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview via phone, expected to take 10-15 minutes.

Responsibilities

• Develop business processes for successful submission and reconciliation of encounter submissions to Medicaid.
• Ensure encounter submissions meet or exceed compliance standards through data analysis.
• Develop tools to enhance the encounter acceptance rate by Medicaid.
• Identify and implement long-term improvements for encounter submission processes.
• Advise executives on functional strategies concerning encounter data management.
• Exercise independent judgment and decision-making on complex job-related tasks.
• Ensure data integrity for claims errors.
• Manage multiple tasks and deadlines with a high degree of accuracy.
• Collaborate with multiple departments to achieve objectives.
• Deliver presentations to senior leadership.

Additional Information

• This position is eligible for a bonus.
• Occasional travel to Humana's offices for training or meetings may be required.