Encounter Data Management Lead

Humana Inc; Louisiana; Remote; USD 94,000 - 131,000; Full time

Job summary

A leading healthcare company is seeking an Encounter Data Management Lead to elevate health standards through efficient data handling. The ideal candidate will enhance encounter submissions accuracy, driving compliance and strategic improvements within the department. This remote position requires significant expertise in healthcare data processes and project management, with a base salary range reflecting job-related skills and experience.

Benefits

Medical benefits

401(k) retirement savings plan

Paid time off

Short-term and long-term disability insurance

Life insurance

Qualifications

• 2+ years of experience with encounter data submissions related to Medicaid required.
• Proven project leadership experience essential.
• Extensive knowledge of Microsoft Office applications is crucial.

Responsibilities

• Develop business processes for encounter submissions to Medicaid.
• Ensure compliance and enhance acceptance rates through data analysis.
• Advise executives on functional strategies and improvements.

Skills

Communication

Problem Solving

Organizational Skills

Attention to Detail

Project Leadership

Education

Master's Degree in Business Administration or a related field

Tools

Microsoft Office

Job description

Become a part of our caring community and help us put health first

The Encounter Data Management Lead develops business processes to ensure successful submission and reconciliation of encounter submissions to Medicaid. Ensures encounter submissions meet or exceed all compliance standards via analysis of data and develops tools to enhance the encounter acceptance rate by Medicaid. Looks for long term improvements of encounter submission processes. Advises executives to develop functional strategies (often segment specific) on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, uses independent judgment requiring analysis of variable factors and determining the best course of action.

The Encounter Data Management Lead ensures data integrity for claims errors. The Encounter Data Management Lead works on problems of diverse scope and complexity ranging from moderate to substantial.

Use your skills to make an impact

Location Requirement: This position is open to candidates who are 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 problems 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 healthcare or insurance setting

Additional Information

Work-At-Home Requirements

• WAH requirements: Must have the ability to provide a high-speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
• A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.
• Satellite and Wireless Internet service is NOT allowed for this role.
• A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Interview Format

As part of our hiring process, we will be using an exciting interviewing technology provided by HireVue, a third-party vendor.This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.

If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.$94,900 - $130,500 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About us

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.