Become a part of our caring community and help us put health first
Humana Healthy Horizons in Oklahoma is seeking a Senior Encounter Data Management Professional who 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.
You will be part of a caring community at Humana. When you meet us, you can tell we started as a hometown company. We’re proud of our Louisville roots and, as we’ve grown, that community feeling has spread across all 50 states and Puerto Rico. No matter where you are—whether you’re working from home, from the field, from our offices, or from somewhere in between—you’ll feel welcome here. We’re a caring community made of close-knit teams, cross-country friendships, and inclusive resource groups, all gathered around one big table where everyone’s voice is heard and respected. Community is a verb here. It’s up to each of us to care for it and maintain it. Because the relationships we form will help us deliver better health outcomes for the people we so proudly serve.
Are you Caring, Curious and Committed? If so, apply today!
The Senior Encounter Data Management Professional:
- Ensures data integrity for claims errors
- Works assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors
- 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
Use your skills to make an impact
Required Qualifications
- Must reside in Oklahoma
- Bachelor's degree in Business, Finance, Operations or other related fields - OR - 5 or more years of encounter data management experience
- Prior experience in a fast paced insurance or health care setting
- 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
- Willing to travel to office in Oklahoma City when needed.
Preferred Qualifications
- Master's Degree in Business Administration or a related field
- Prior demonstrated experience with project management
- Prior experience with Medicare and Medicaid programs
- Six Sigma certification a plus
Work at Home Guidance
To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
Satellite, cellular and microwave connection can be used only if approved by leadership
Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Interview Format
As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
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.
$69,800 - $96,200 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.
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.
