Encounter Data Management Lead

Humana

1d • Remote

About The Position

The Encounter Data Management Lead provides strategic oversight of AI‑driven reconciliation and automation initiatives to improve data quality and operational efficiency. This role partners across teams to guide model performance, communicate progress, and prioritize enhancements while independently navigating complex challenges. The Encounter Data Management Lead develops AI tools and business process to reduce/eliminate errors or automate manual steps. Monitor AI reconciliation stats to determine success of AI model. Collaborate on model changes to improve reconciliation success and collaborate on AI automation and systematic automation. Present out to partners on progress of AI modeling, errors that are on the backlog and create roadmap for backlogged work. Exercises independent on complex issues regarding job duties and related tasks, and works, uses requiring analysis of variable factors and determining the best course of action. This position reports to the Director, Encounter Data Management.

Requirements

• 4 or more years of AI modeling experience
• 4 or more years working with encounter data
• 2 or more years of project management experience
• 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.
• A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

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

• Lead and manage AI‑driven reconciliation and automation initiatives to reduce encounter data errors and eliminate manual processes.
• Monitor and evaluate AI reconciliation performance metrics; identify issues and drive targeted model and process enhancements.
• Partner with technical and business stakeholders to communicate AI performance, backlog status, and automation priorities; maintain a remediation roadmap.
• Independently analyze and resolve complex encounter data and automation challenges using sound judgment with minimal supervision; report to the Director, Encounter Data Management.

Benefits

• medical
• dental
• 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

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree