Manager, Encounter Data Management
hace 4 semanas
Location field must contain 'city, state' or a zip code to perform a radius search (e.g., Denver, CO or 46122 ). City and state must be separated by a comma followed by a space (e.g., Houston, TX )
Humana Manager, Encounter Data Management in Santa Fe, New MexicoBecome a part of our caring community and help us put health first
The Manager, 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 resources, approach, and tactical operations for projects and initiatives involving own departmental area. Requires cross-departmental collaboration and conducts briefings and area meetings; maintains frequent contact with other managers across the department.
The Manager, Encounter Data Management leads a team of associates who develop efficient business processes for Error Corrections associates and ensures successful submission and reconciliation of encounter submissions across multiple Medicare/Medicaid trading partners. Ensures Medicare/Medicaid encounter submissions meet or exceed all compliance standards via analysis of data and develops tools to enhance the encounter acceptance rate for Medicare/Medicaid trading partners. Looks for long-term improvements and/or automation for error corrections processes. Plays a key role in influencing departmental strategy, makes decisions on resources, approach, and operations of day-to-day focus, and establishes the team as subject matter experts when it is related to the resolution of error. Exercises considerable latitude in determining objectives to exceed goals and can effectively communicate objectives and accomplishments to upper management.
Use your skills to make an impact
Required Qualifications
- Bachelor's degree in Business, Finance, Operations or other related fields or 3+ years with Medicare and/or Medicaid claims processing or auditing experience
- 2+ years of leadership, coaching and/or team leadership experience
- Demonstrated problem-solving skills; ability to give direction and make sound business decisions
- Ability to develop and present information to senior leadership
- Experience with analyzing and visualizing large data sets
- Ability to manage multiple tasks and deadlines with attention to detail
- Prior experience in a fast-paced insurance or health care setting
- Self-starter, ability to work independently
- Ability to manage multiple priorities simultaneously
- Comprehensive knowledge of all Microsoft Office applications, including Word, PowerPoint, Outlook, and Intermediate Excel skills
Preferred Qualifications
- Working knowledge of Edifecs and HERO applications
- 1+ years' experience working in CAS and CI
- Working knowledge of SQL writing, creating, and/or running queries (ORACLE, Microsoft SQL Server)
- 1+ years of X-12 data knowledge
Additional Information
Work-At-Home Requirements
- WAH requirements: Must have the ability to provide a high-speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
- 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
Interview Format
As part of our hiring process, we will be using an exciting interviewing technology provided by HireVue, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.
If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.
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 will vary based on demonstrated job-related skills, knowledge, experience, education, certifications, etc.
$86,300 - $118,700 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.
Application Deadline: 04-03-2025
About us
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 veteran status. 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.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our accessibility resources.
#J-18808-Ljbffr-
Encounter Process Specialist
hace 2 semanas
Rosario, Santa Fe, Argentina Humana A tiempo completoJob Summary: As a Encounter Process Specialist at Humana, you will play a key role in optimizing our encounter process to ensure successful submission and reconciliation of encounter submissions to Medicaid/Medicare. With your expertise in Medicare and/or Medicaid claims processing or auditing experience, you will analyze data to identify areas for...
-
Data Management Lead
hace 2 semanas
Rosario, Santa Fe, Argentina Humana A tiempo completoJob Overview: Humana seeks an experienced professional to lead our data management efforts and optimize business processes. As a Data Management Lead, you will develop and implement strategies to ensure successful submission and reconciliation of encounter submissions to Medicaid/Medicare.About the Role: We are looking for a skilled professional with...
-
Business Process Optimization Manager
hace 2 semanas
Rosario, Santa Fe, Argentina Humana A tiempo completoBusiness Process Optimization Manager Job Description: Humana is seeking an experienced Business Process Optimization Manager to lead our data management efforts and optimize business processes. As a Business Process Optimization Manager, you will develop and implement strategies to ensure successful submission and reconciliation of encounter submissions to...
-
Data Systems Manager
hace 1 semana
Rosario, Santa Fe, Argentina Sfrecovery A tiempo completoSfrecovery seeks a highly skilled Data Systems Manager to join our team. As a key member of the organization, you will support the Director of Practice Management Systems in optimizing data workflows, maintaining practice management systems, and providing data-driven insights to inform organizational strategy.This role requires collaboration with various...
-
Manager, Vulnerability Management
hace 4 semanas
Rosario, Santa Fe, Argentina Baylor Scott & White Health A tiempo completoBaylor Scott & White Health Manager, Vulnerability Management in Santa Fe, New MexicoJob SummaryAs the Manager of Vulnerability Management, you will play a key role in the success of the vulnerability and configuration management program by identifying security risks, prioritizing actions based on intelligence-driven processes, and proactively responding to...
-
Property Management Manager
hace 4 semanas
Rosario, Santa Fe, Argentina CBRE A tiempo completoCBRE Property Management Manager - Remote Southern California in Santa Fe, New MexicoJob ID: 208819Posted: 10-Mar-2025Service line: Property ManagementRole type: Full-timeAreas of Interest: Property ManagementLocation(s): Long Beach, California, Remote - US, San Bernardino, California, Santa Maria, CaliforniaJOB SUMMARYGet ready for an exciting career with...
-
Human Capital Data Manager
hace 2 semanas
Rosario, Santa Fe, Argentina RWS Group A tiempo completoRWS Group has an opening for a Human Capital Data Manager to join their team in Rosario, Argentina.This role involves working closely with the HR team to manage and maintain accurate and up-to-date human capital data. Key responsibilities include:Data entry and submission in local payroll systems.Executing interfaces between the HR platform and local payroll...
-
Project Management Manager
hace 4 semanas
Rosario, Santa Fe, Argentina Secunm A tiempo completoPosition Title: Project Management ManagerREPORTS TO: EVP/Chief Operations OfficerSUPERVISES: N/AJOB STATUS: ExemptJOB GRADE 14: $77,920.13 - $97,400.16 Targeted Annual SalaryThis position works on-site. Remote work is not available at this time.JOB SUMMARY:The Project Management Manager is responsible for overseeing the planning, implementation, and...
-
Patient Care Services Manager
hace 2 semanas
Rosario, Santa Fe, Argentina Christus Health A tiempo completoChristus Health Job DescriptionThe Patient Care Services Manager will oversee the operations of patient care services at Christus Health. Key responsibilities include:Managing scheduling and staffing processesDeveloping reports and dashboards to inform decision-makingMaintaining accurate records and dataThis role requires a high level of organization, time...
-
Marketing Workflow Manager
hace 2 semanas
Rosario, Santa Fe, Argentina Neo-Biz Consultores A tiempo completoWe're seeking a Marketing Workflow Manager to join our team at Neo-Biz Consultores. As a key member of our marketing operations team, you'll be responsible for managing end-to-end workflow processes for marketing campaigns, from conceptualization to execution.About the RoleThis is an exciting opportunity to work on scalable marketing operations processes...
-
Manager, Clean Energy Asset Management
hace 4 semanas
Rosario, Santa Fe, Argentina Meta A tiempo completoLocation field must contain 'city, state' or a zip code to perform a radius search (e.g., Denver, CO or 46122 ). City and state must be separated by a comma followed by a space (e.g., Houston, TX )Summary:The Manager of Clean Energy Asset Management will lead a team of Energy Managers whose responsibilities span all issues post contract execution of Meta's...
-
Practice Management Support
hace 1 semana
Rosario, Santa Fe, Argentina Sfrecovery A tiempo completoSfrecovery is seeking an experienced Practice Management Support specialist to join our team. In this role, you will work closely with the Director of Practice Management Systems to maintain and improve the agency's practice management systems, ensuring they meet organizational needs and goals.Key responsibilities include:Maintaining and improving EHR/EMR...
-
Business Management Trainee
hace 21 horas
Rosario, Santa Fe, Argentina beBee Careers A tiempo completoRole Summary:We are seeking an ambitious and driven individual to join our team as an Operations Manager Trainee. In this role, you will undergo extensive training to develop your leadership and management skills, ultimately preparing you to independently manage a dental office.You will be responsible for learning and implementing company policies,...
-
Healthcare Data Analyst
hace 1 semana
Rosario, Santa Fe, Argentina Sfrecovery A tiempo completoWe are looking for a highly skilled Healthcare Data Analyst to join our team at Sfrecovery. In this role, you will support the Director of Practice Management Systems in analyzing and interpreting data to inform organizational strategy and decision-making.Key responsibilities include:Analyzing and interpreting data from practice management systems to...
-
Data Center Network Infrastructure Manager
hace 2 semanas
Rosario, Santa Fe, Argentina Meta A tiempo completoRequired Skills and QualificationsTechnical Leadership: Provide expert guidance on technical issues related to data center architecture, hardware platforms, and vendor performance.Operational Excellence and Team Leadership: Own the planning and execution of organizational-level strategies to deliver operational excellence.Innovation: Spearhead research and...
-
Management Development Program
hace 21 horas
Rosario, Santa Fe, Argentina beBee Careers A tiempo completoAbout the Role:We are seeking an exceptional individual to join our team as an Operations Manager Trainee. This is a unique opportunity to develop your leadership and management skills in a dynamic and fast-paced environment.In this role, you will be responsible for leading teams, managing budgets, and driving revenue growth, while maintaining a focus on...
-
HR Operations Manager
hace 4 semanas
Rosario, Santa Fe, Argentina Heru Human Resource Specialist Co. Inc. A tiempo completoJob Title: HR Operations ManagerJob Qualification:Qualifications:Education: Bachelor's degree in Business Administration, Management, Human Resources, or related field. Master's degree is a plus.Experience: At least 5 years of experience in operations management, preferably in the manpower service provider industry. Proven experience in managing a team and...
-
Manager, Marketing Operations
hace 2 semanas
Rosario, Santa Fe, Argentina Neo-Biz Consultores A tiempo completoManager, Marketing Operations - Buenos Aires, ArgentinaBuild Your Career | Have Fun | Make a Difference Payoneer's mission is to empower businesses to go beyond - beyond borders, limits and expectations.In today's digital world, Payoneer enables any business of any size from anywhere to access new economic opportunities by making it possible to transact as...
-
Data and Systems Coordinator
hace 3 semanas
Rosario, Santa Fe, Argentina Sfrecovery A tiempo completoSUMMARY:The Data and Systems Coordinator supports the Director of Practice Management Systems in optimizing data workflows, maintaining practice management systems, and providing data-driven insights to assist in organizational strategy across the agency. This role works collaboratively across departments to streamline processes, assist in the improvement of...
-
Manager, Marketing Operations
hace 3 semanas
Rosario, Santa Fe, Argentina NEO-BIZ Consultores A tiempo completoManager, Marketing Operations - Buenos Aires, ArgentinaBuild Your Career | Have Fun | Make a DifferencePayoneer's mission is to empower businesses to go beyond - beyond borders, limits and expectations. In today's digital world, Payoneer enables any business of any size from anywhere to access new economic opportunities by making it possible to transact as...