Remote Encounter Data Submissions Lead

Openkrill; United States; Remote; USD 120,000 - 180,000; Full time

Benefits offered by this job

Flexible work schedules

Health insurance

PTO and holidays

Remote-friendly culture

Job summary

Aledade PBC is seeking a Program Manager for the Encounter Data Submissions program. You will lead the end-to-end initiative, crafting program guides and SOPs, assess ROI of ASM workflows, and drive process improvements across payer submissions.

The role emphasizes cross-functional leadership and ensuring data accuracy for payers and CMS. The ideal candidate will oversee daily EDS reconciliation, work in a remote-friendly US environment, and collaborate with senior leadership to maintain

Qualifications

• Bachelor's degree in Business, Finance, IT, Analytics, Operations, or related field.
• 4+ years of experience with Medicare Advantage or ACA encounter data processes and/or risk adjustment with a payer, vendor or provider organization.
• 1+ years of X-12 837 data knowledge.
• Strong analytical skills with ability to interpret complex data sets and identify insights.
• Ability to present information to senior leadership.
• Proficiency in SQL: writing, creating and running queries.
• Proficiency with Microsoft Office Suite, SharePoint, Jira, Smartsheet.

Responsibilities

• Assist in developing programming documentation and SOPs, including maintenance of program documents.
• Identify and establish ASM processes with eligible payers.
• Support senior leadership to increase practice opt-in to ASM processes.
• Create and transmit ASM files to payers on an established cadence.
• Maintain CMS and payer submission deadlines and payer templates annually.
• Reconcile ASM submissions with payer and CMS EDS files and establish routine reconciliation.
• Oversee daily EDS and reconciliation processes; ensure data accuracy and submission integrity.
• Collaborate with leadership and legal to ensure regulatory compliance for submissions.

Skills

SQL

Analytics

Data interpretation

Senior leadership

Microsoft Office

Project management

Education

Bachelor's degree

Tools

Jira

Smartsheet

SharePoint

Relational databases

Job description

Aledade PBC is seeking a Program Manager for the Encounter Data Submissions program. You will lead the end-to-end initiative, crafting program guides and SOPs, assess ROI of ASM workflows, and drive process improvements across payer submissions.

The role emphasizes cross-functional leadership and ensuring data accuracy for payers and CMS. The ideal candidate will oversee daily EDS reconciliation, work in a remote-friendly US environment, and collaborate with senior leadership to maintain