Senior Encounter Data Management Professional

Humana • Indianapolis, IN

1d • Remote

About The Position

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

Requirements

• 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

Nice To Haves

• 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

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.
• 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.
• Ensures data integrity for claims errors.

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: Senior