Senior Encounter Data Management Professional
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Role details
Tech stack
Job description
The Senior Encounter Data Management Professional develops business processes to ensure successful submission and reconciliation of encounter submissions to Medicaid/Medicare. Ensures encounter submissions meet or exceed all compliance standards via analysis of data, and develops tools to enhance the encounter acceptance rate by Medicaid/Medicare. Sources data within the data warehouse aiding in the creation of new state layout extracts. Looks for long term improvements of encounter submission processes. Begins to influence department’s strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments., Travel: While this is a remote position, occasional travel to Humana’s offices for training or meetings may be required.
Scheduled Weekly Hours
40
Requirements
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Bachelor’s degree in Business, Data Management, Operations or other related fields
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5 or more years of related experience
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Demonstrated proficiency in SQL or Microsoft Access coding
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Ability to manage multiple tasks and deadlines with attention to detail
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Excellent communication skills
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Self-starter, ability to work independently
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Ability to manage multiple priorities simultaneously
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Comprehensive knowledge of all Microsoft Office applications, including Word, PowerPoint, Outlook, and Excel
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Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Preferred Qualifications
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Master’s Degree in Business Administration or a related field
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Prior demonstrated experience with pharmacy claims and encounters
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Prior experience with Medicare and Medicaid programs
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Six Sigma certification a plus
Benefits & conditions
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.
$78,400 - $107,800 per year
This 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 the company
About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our 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 and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.
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