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Job Profile
Senior Encounter Data Management ProfessionalJob Level
Senior Professional
Become a part of our caring community
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.
The Senior Encounter Data Management Professional ensures data integrity for claims errors. The Senior Encounter Data Management Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
Use your skills to make an impact
Required Qualifications
- Bachelor's degree in Business, Data Management, Operations or other related fields
- 5 or more years of related experience
- Demonstrated proficiency in SQL or Microsoft Access coding
- Ability to manage multiple tasks and deadlines with attention to detail
- Excellent communication skills
- Self-starter, ability to work independently
- Ability to manage multiple priorities simultaneously
- 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
- Prior demonstrated experience with pharmacy claims and encounters
- Prior experience with Medicare and Medicaid programs
- Six Sigma certification a plus
Additional Information
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.Scheduled Weekly Hours
40Pay 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.
Referral Bonus Information
This requisition is not eligible for a referral bonus.
About us
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.
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.