Encounter Data & Regulatory Analytics Manager

 We’re hiring an Encounter Data & Regulatory Analytics Manager with strong SQL programming skills with the ability to query, analyze, and validate complex data sets.

Experience working with healthcare EDI transactions, specifically 837 Dental (837D) and/or 837 Professional (837P) claims, is highly preferred. 

The Manager, Encounter Data & Regulatory Analytics is a hands-on technical leader responsible for overseeing encounter data submissions, regulatory reporting, and audit support across Medicaid and Medicare lines of business. This role combines leadership with deep technical execution, serving as a key partner to the AVP while ensuring compliance, accuracy, and delivery of high-impact analytics.

What You’ll Do

Regulatory Reporting & Encounter Data

• Manage day-to-day execution of encounter data submissions and regulatory reporting

• Serve as a subject matter expert on encounter workflows, reporting logic, and system processes

• Ensure accuracy, completeness, and compliance across all regulatory deliverables

Analytics & Technical Execution

• Perform hands-on SQL analysis, data validation, and complex reporting development

• Translate regulatory and client requirements into actionable analytic solutions

• Maintain and enhance reporting processes to ensure audit readiness and consistency

Audit & Compliance Support

• Lead analytic support for regulatory audits, data validations, and examinations

• Investigate data issues and provide clear, actionable resolutions

• Ensure reporting processes meet audit and compliance standards

Leadership & Team Development

• Lead, mentor, and develop a team of analysts responsible for reporting deliverables

• Provide guidance on technical analysis and regulatory requirements

• Support team prioritization and workload management

Cross-Functional Collaboration

• Partner with IT, Compliance, Operations, and business stakeholders to resolve system and data issues

• Support new group implementations, benefit changes, and complex client reporting

• Act as a key escalation point and functional backup to the AVP

What Sets This Role Apart

• Clear path to AVP-level progression with direct leadership exposure

• High-impact role supporting regulatory compliance and enterprise-wide reporting

• Blend of hands-on technical work and people leadership

Education & Experience

• Bachelor’s degree in Information Technology, Information Science, or a related field required

• 6+ years of experience in healthcare analytics, encounter data, or regulatory reporting

• Medicaid and/or Medicare experience required

• 2+ years of leadership or team management experience preferred

Core Capabilities

• Advanced SQL skills with the ability to analyze and validate complex datasets

• Deep knowledge of Medicaid and Medicare encounter data and reporting requirements

• Strong understanding of healthcare data structures and system workflows

• Proven experience supporting audits, data validation, and issue resolution

• Ability to lead and mentor technical teams effectively

• Strong communication skills across technical and non-technical stakeholders

• Ability to prioritize and manage deadlines in a fast-paced, regulatory environment

Why Join

• Opportunity to lead critical regulatory analytics in a mission-driven healthcare organization

• Clear career progression into executive-level leadership

• Collaborative, high-performing team with strong technical focus

Apply Today

If you’re a technical leader who thrives in complex, data-driven environments and is passionate about regulatory excellence, we encourage you to apply.