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Encounter Data Management Lead

$94.9k - $130.5k

Humana Inc

Become a part of our caring community The Encounter Data Management Lead provides strategic oversight of AI‑driven reconciliation and automation initiatives to improve data quality and operational efficiency. The role partners across teams to guide model performance, communicate progress, and prioritize enhancements while independently navigating complex challenges. Responsibilities Lead and manage AI‑driven reconciliation and automation initiatives to reduce encounter data errors and eliminate manual processes. Monitor and evaluate AI reconciliation performance metrics; identify issues and drive targeted model and process enhancements. Partner with technical and business stakeholders to communicate AI performance, backlog status, and automation priorities; maintain a remediation roadmap. Independently analyze and resolve complex encounter data and automation challenges using sound judgment with minimal supervision; report to the Director, Encounter Data Management. Required Qualifications 4 or more years of AI modeling experience 4 or more years working with encounter data 2 or more years of project management experience Preferred Qualifications Master's Degree in Business Administration or a related field Certification in Six Sigma or Project Management Prior Experience in healthcare or insurance setting Work‑At‑Home 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 25×10 (25mpbs download × 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 Pay Range $94,900 - $130,500 per year 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. 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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with 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 website at #J-18808-Ljbffr Humana Inc

Vacancy posted 3 days ago
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