Associate Director, Encounter Data Management

Humana

2d • $104,000 - $143,000 • Remote

About The Position

Become a part of our caring community and help us put health first The Associate Director, Encounter Data Management 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. Looks for long term improvements of encounter submission processes. Decisions are typically related to identifying and resolving complex technical and operational problems within department(s), and could lead multiple managers or highly specialized professional associates. The Associate Director, Encounter Data Management ensures data integrity for all aspects of encounter submission errors. The Associate Director, Encounter Data Management requires a solid understanding of how organization capabilities interrelate across department(s) to ensure the workflow is maximized and to ensure communication channels are always open. Strong attention to process maximization and improvements to ensure that throughput is consistently handled. Will look to improve performance on year over year basis as technology and processes are mastered. Use your skills to make an impact

Requirements

• Bachelor's Degree or equivalent industry experience
• 6 or more years of technical / claims / encounter experience
• 3 or more years of management 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
• Must have the ability to provide a high-speed DSL or cable modem for a home office.
• 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.

Nice To Haves

• Master's Degree in Business Administration or a related field
• Certification in Six Sigma or Project Management
• Prior Experience in healthcare or insurance setting

Responsibilities

• 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
• Develops tools to enhance the encounter acceptance rate by Medicaid/Medicare.
• Looks for long term improvements of encounter submission processes.
• Ensures data integrity for all aspects of encounter submission errors.
• Requires a solid understanding of how organization capabilities interrelate across department(s) to ensure the workflow is maximized and to ensure communication channels are always open.
• Improve performance on year over year basis as technology and processes are mastered.

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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees