Encounter Data Management Lead

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

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.

The Encounter Data Management Lead will drive the business connection for the migrations of contracts to various systems. Ensures migrations meet or exceed all business needs via analysis of data, meeting timelines and complete validation of changes. 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.

This position reports to the Director, Encounter Data Management.

• 5 + years working with encounter data, claims, or EDI transactions
• 5 or more years of system migrations with proven results of on time delivery
• 2 or more years of project leadership experience with multiple departments
• 2 or more years work on agile development team
• Experience working with ADO or Jira align
• 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
• Demonstrated experience delivering presentations to senior leadership

• Master's degree in business administration or a related field
• Certification in Six Sigma or Project Management
• Prior experience in healthcare or insurance setting

• 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

As part of our hiring process, we will be using an exciting interviewing technology provided by Hire Vue, 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.

40

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 year. This job is eligible for a bonus incentive plan.

This incentive opportunity is based upon company and/or individual performance.

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…