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

　　The Encounter Data Management Lead 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 pulling, data analysis, and develops tools to enhance the encounter acceptance rate by Medicaid/Medicare. Looks for long term improvements of encounter submission processes. Advises executives to develop functional strategies (often segment specific) on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, Uses independent judgment requiring analysis of variable factors and determining the best course of action.

　　The Encounter Data Management Lead ensures data integrity for claims errors. The Encounter Data Management Lead works on problems of diverse scope and complexity ranging from moderate to substantial. This would be accomplished by doing end to end analysis of encounter submissions to identify new data and methods for long term resolution. The lead will oversee business side of release management for multiple IT teams.

　　This is a remote position.

　　#LI-Remote

　　Required Qualifications

　　4+ years of requirements writing or UAT validations4+ of SQL data pulling and data analysis3+ years leading associates3+ years of claims/encounter processingPrior demonstrated experience with process improvementsAbility to manage multiple tasks and deadlines with attention to detailDemonstrated problems solving skills; ability to give direction and make sound business decisionsProven organizational and prioritization skills and ability to collaborate with multiple departmentsAbility to deliver presentations to senior leadershipComprehensive knowledge of all Microsoft Office applications, including Word, PowerPoint, Outlook, and Excel

　　Preferred Qualifications

　　a Bachelor's degreeCAS or MTV experienceX12 ExperienceCertification in Six Sigma or Project ManagementPrior Experience in healthcare or insurance setting

　　Additional Information

　　Why Humana? You'll experience the following perks as a full-time Humana employee:

　　Compensation and Financial Security - Our pay philosophy is designed to motivate and reward associates for their skills and contributions to the company. We provide options to help you plan for your future and protect your assets: Competitive base pay, Recognition pay, 401(k) retirement savings plan (125% match for the first 6% contributed by an associate), etc.

　　Your Whole Health - Humana's health products and services are designed to encourage personal wellness and smart healthcare decisions for you and your family: Medical, dental, and vision benefits, Health plan incentives, Paternity leave, etc.

　　Work Perks - Humana knows your life extends outside of work. We have many options to support your interests and needs. Some departments have the flexibility to allow associates to work from home, and we offer all associates: Paid time off, holidays, volunteer time, jury duty pay, Associate charity matching program, Discount programs with major retailers, etc.

　　Grow With Us - Humana provides growth and career opportunities that can help you develop your skills and build your future with the organization: Internal and external learning events, Tuition assistance, Inclusion and diversity training, etc.

　　Social Security Task:

　　Alert: Humana values personal identity protection. Please be aware that applicants being considered for an interview will be asked to provide a social security number, if it is not already on file. When required, an email will be sent from [email protected] with instructions to add the information into the application at Humana's secure website.

　　Interview Format:

　　As part of our hiring process for this opportunity, you may be utilizing our interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information for you pertaining to your relevant skills and experience at a time that is best for your schedule.

　　If you are selected for a first round interview, you will receive an email correspondence inviting you to participate in a Modern Hire interview. In this interview, you will receive a set of interview questions over your phone and you will provide recorded or text message responses to each question. You should anticipate this interview to take about 15 minutes. Your recorded interview will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews.

　　Scheduled Weekly Hours

　　40

　　Pay 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 decisions will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

　　$76,800 - $105,800 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.

　　Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large.

　　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 because he or she is a protected veteran. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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.