Encounters Technical Lead
for headings: About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. We need to decide which sections have content.
From posting: There's a description: "Come join Peak Health to help launch a Medicare Advantage plan. We are seeking a highly skilled and experienced professional to join our organization as an Encounters Technical Lead. Reporting to the Manager..." That's about the role. So we can have About the role section.
Responsibilities: "CORE DUTIES AND RESPONSIBILITIES:" with bullet-like paragraphs. We'll put that under Responsibilities.
Requirements: Minimum qualifications: education, experience. Could be Requirements section.
Preferred qualifications: maybe Qualifications section (or combine). The instruction: Use headings for sections like Requirements, Qualifications, Skills, Benefits, Pay, Schedule. So we can have Requirements (minimum) and Qualifications (preferred). Or we could combine but better separate.
Skills: "SKILLS AND ABILITIES:" list. So Skills section.
Benefits: Not mentioned. No benefits info. So we should NOT include Benefits heading.
Pay: Not mentioned. So no Pay.
Schedule: There's "Scheduled Weekly Hours: 40 Shift: Day (United States of America) Exempt/Non-Exempt: United States of America (Exempt)". That's schedule info. So we can include Schedule section.
We must not repeat job title as heading. Also not include Job ID etc.
We must preserve all substantive info, not invent. Remove boilerplate like "Welcome! We’re excited..." etc. Also remove application instructions, EEO, etc. Also remove "Physical Requirements", "Working Environment" maybe not needed as they are not requested headings; but we could include if relevant? Not in allowed headings list. We should drop them unless we can fit into existing sections? Probably drop.
We need to use - for any list of duties/requirements/benefits. So for responsibilities, requirements, qualifications, skills we should convert sentences into list items where appropriate. However the instructions: "Use
- for any list of duties/requirements/benefits, and
for prose." So we need to identify lists. The posting has bullet-like sentences but not explicit list formatting. We can treat each duty as a list item. For responsibilities we have multiple paragraphs each starting with a bold heading? Actually the text: "Encounter Data Management:Oversee the end-to-end management..." etc. It's a run-on. We could split by sentences after colon? Better to treat each major duty as a list item. We'll parse.
Responsibilities sections:
- Encounter Data Management: Oversee the end-to-end management of encounters data, including data ingestion, data cleansing, data transformation, and data integration. Develop and implement best practices for encounters data processing. Collaborate with internal and external stakeholders to establish effective data integration processes. Coordinate with IT teams and vendors to ensure smooth and accurate data exchange between systems and platforms. Design and develop encounter data models, ensuring they align with industry standards and organizational requirements. Optimize data models to support efficient data retrieval and analysis. Establish monitoring mechanisms to track the performance and efficiency of encounters data processes. Identify opportunities for optimization and implement appropriate measures to enhance system performance.
- Technical Leadership: Provide technical expertise and guidance in encounters data management and analysis. Set clear technical objectives and expectations, and lead by example in delivering high-quality solutions. Ability to work collaboratively across many teams, prioritize demands from those teams, synthesize information received, and generate meaningful conclusions. Develop and implement training programs to enhance the skills and knowledge of the team.
- Compliance and Reporting: Implement quality assurance processes and conduct regular audits to ensure data accuracy and integrity. Identify and resolve data-related issues promptly, collaborating with cross-functional teams as necessary. Utilize advanced analytics techniques to extract meaningful insights from encounter data. Work closely with analytics teams to define data requirements and support the development of analytical models and reports. Ensure compliance with all applicable regulatory requirements, guidelines, and contractual obligations related to Encounter Submissions (837P, 837I) and Response Files (277CA, MAO-001, MAO-002, MAO-004) via CMS’ Encounter Data Processing System (EDPS). Must possess current understanding of how compliance and quality programs such as Medicare STARS, HEDIS, and NCQA affect the Plan.
We can make each of these three as list items, but inside each we have multiple sentences; still okay as
- containing multiple sentences.
Requirements (minimum qualifications):
- Education: Bachelor’s Degree in Healthcare Administration, Business Administration, Finance, Economics, Information Systems, or a closely related field
- Experience: Four (4) years of experience in encounter data management, risk adjustment, or related field within the healthcare industry. Four (4) years of experience working with claims data to evaluate reimbursement changes, payment discrepancies, medical expense opportunities, quality outcomes and risk.
We could combine as two list items.
Qualifications (preferred):
- Education: Master’s Degree in Healthcare Administration, Business Administration, Finance, Economics, Information Systems, or a closely related field
- Experience: Five (5) years of experience in encounter data management or related field within the healthcare industry.
- Strong knowledge of CMS’ Encounter Data Processing System (EDPS) data files (837P, 837I, 277CA, MAO-001, MAO-002, MAO-004)
- Knowledge of ICD Diagnosis, CPT, UB, HCFA coding and understanding
- Understanding of CMS Medicare Regulatory Reporting
Skills:
List each skill as
- .
- Strategic thinking
- Excellent written and oral communication
- Demonstrated ability to analyze complex data sets, identify patterns, and derive actionable insights.
- Familiarity with statistical analysis and machine learning techniques is a plus.
- Exceptional problem-solving and critical-thinking abilities, with a keen attention to detail.
- Ability to identify and resolve technical issues in a timely manner.
- Attention to detail
- Experience with Medicare and Medicaid products
- Working knowledge of claims, utilization management, member, and/or provider data
- Effective time management and organizational skills.
- Flexibility to adapt to changing priorities and business needs.
- Ability to thrive in a fast-paced and dynamic environment.
- Work independently as well as in a team environment
- Proficient with Microsoft Office
- Proficiency in data integration tools and techniques.
- Strong knowledge of database management systems (e.g., SQL, NoSQL), data modeling, ETL processes, and data warehousing concepts.
- Experience with data visualization and analytics tools (e.g., SAS, Tableau, Power BI) is preferred.
- Proven experience in leading technical projects.
- Strong interpersonal and communication skills to effectively collaborate with cross-functional stakeholders.
Schedule:
- Scheduled Weekly Hours: 40
- Shift: Day (United States of America)
- Exempt/Non-Exempt: Exempt (United States of America)
We could combine into one
or list. Since schedule is not a list of duties but info, we can use
. But instruction: Use
- for any list of duties/requirements/benefits. Schedule is not duties/requirements/benefits, so we can use
. We'll output a
with the schedule details.
Now produce HTML fragment:
About the role
Come join Peak Health to help launch a Medicare Advantage plan. We are seeking a highly skilled and experienced professional to join our organization as an Encounters Technical Lead. Reporting to the Manager, Encounters & Risk Adjustment, the Encounters Technical Lead will play a pivotal role in our organization by overseeing the technical aspects of encounters data management and analysis. This role requires a strong understanding of healthcare encounters data, as well as expertise in data integration, data modeling, and data analytics. The successful candidate will collaborate closely with cross-functional teams to ensure accurate and efficient processing of encounters data.
Responsibilities
- Encounter Data Management: Oversee the end-to-end management of encounters data, including data ingestion, data cleansing, data transformation, and data integration. Develop and implement best practices for encounters data processing. Collaborate with internal and external stakeholders to establish effective data integration processes. Coordinate with IT teams and vendors to ensure smooth and accurate data exchange between systems and platforms. Design and develop encounter data models, ensuring they align with industry standards and organizational requirements. Optimize data models to support efficient data retrieval and analysis. Establish monitoring mechanisms to track the performance and efficiency of encounters data processes. Identify opportunities for optimization and implement appropriate measures to enhance system performance.
- Technical Leadership: Provide technical expertise and guidance in encounters data management and analysis. Set clear technical objectives and expectations, and lead by example in delivering high-quality solutions. Ability to work collaboratively across many teams, prioritize demands from those teams, synthesize information received, and generate meaningful conclusions. Develop and implement training programs to enhance the skills and knowledge of the team.
- Compliance and Reporting: Implement quality assurance processes and conduct regular audits to ensure data accuracy and integrity. Identify and resolve data-related issues promptly, collaborating with cross-functional teams as necessary. Utilize advanced analytics techniques to extract meaningful insights from encounter data. Work closely with analytics teams to define data requirements and support the development of analytical models and reports. Ensure compliance with all applicable regulatory requirements, guidelines, and contractual obligations related to Encounter Submissions (837P, 837I) and Response Files (277CA, MAO-001, MAO-002, MAO-004) via CMS’ Encounter Data Processing System (EDPS). Must possess current understanding of how compliance and quality programs such as Medicare STARS, HEDIS, and NCQA affect the Plan.
Requirements
- Education: Bachelor’s Degree in Healthcare Administration, Business Administration, Finance, Economics, Information Systems, or a closely related field
- Experience: Four (4) years of experience in encounter data management, risk adjustment, or related field within the healthcare industry. Four (4) years of experience working with claims data to evaluate reimbursement changes, payment discrepancies, medical expense opportunities, quality outcomes and risk.
Qualifications
- Education: Master’s Degree in Healthcare Administration, Business Administration, Finance, Economics, Information Systems, or a closely related field
- Experience: Five (5) years of experience in encounter data management or related field within the healthcare industry.
- Strong knowledge of CMS’ Encounter Data Processing System (EDPS) data files (837P, 837I, 277CA, MAO-001, MAO-002, MAO-004)
- Knowledge of ICD Diagnosis, CPT, UB, HCFA coding and understanding
- Understanding of CMS Medicare Regulatory Reporting
Skills
- Strategic thinking
- Excellent written and oral communication
- Demonstrated ability to analyze complex data sets, identify patterns, and derive actionable insights.
- Familiarity with statistical analysis and machine learning techniques is a plus.
- Exceptional problem-solving and critical-thinking abilities, with a keen attention to detail.
- Ability to identify and resolve technical issues in a timely manner.
- Attention to detail
- Experience with Medicare and Medicaid products
- Working knowledge of claims, utilization management, member, and/or provider data
- Effective time management and organizational skills.
- Flexibility to adapt to changing priorities and business needs.
- Ability to thrive in a fast-paced and dynamic environment.
- Work independently as well as in a team environment
- Proficient with
- for any list of duties/requirements/benefits, and
for prose." So we need to identify lists. The posting has bullet-like sentences but not explicit list formatting. We can treat each duty as a list item. For responsibilities we have multiple paragraphs each starting with a bold heading? Actually the text: "Encounter Data Management:Oversee the end-to-end management..." etc. It's a run-on. We could split by sentences after colon? Better to treat each major duty as a list item. We'll parse. Responsibilities sections: - Encounter Data Management: Oversee the end-to-end management of encounters data, including data ingestion, data cleansing, data transformation, and data integration. Develop and implement best practices for encounters data processing. Collaborate with internal and external stakeholders to establish effective data integration processes. Coordinate with IT teams and vendors to ensure smooth and accurate data exchange between systems and platforms. Design and develop encounter data models, ensuring they align with industry standards and organizational requirements. Optimize data models to support efficient data retrieval and analysis. Establish monitoring mechanisms to track the performance and efficiency of encounters data processes. Identify opportunities for optimization and implement appropriate measures to enhance system performance. - Technical Leadership: Provide technical expertise and guidance in encounters data management and analysis. Set clear technical objectives and expectations, and lead by example in delivering high-quality solutions. Ability to work collaboratively across many teams, prioritize demands from those teams, synthesize information received, and generate meaningful conclusions. Develop and implement training programs to enhance the skills and knowledge of the team. - Compliance and Reporting: Implement quality assurance processes and conduct regular audits to ensure data accuracy and integrity. Identify and resolve data-related issues promptly, collaborating with cross-functional teams as necessary. Utilize advanced analytics techniques to extract meaningful insights from encounter data. Work closely with analytics teams to define data requirements and support the development of analytical models and reports. Ensure compliance with all applicable regulatory requirements, guidelines, and contractual obligations related to Encounter Submissions (837P, 837I) and Response Files (277CA, MAO-001, MAO-002, MAO-004) via CMS’ Encounter Data Processing System (EDPS). Must possess current understanding of how compliance and quality programs such as Medicare STARS, HEDIS, and NCQA affect the Plan. We can make each of these three as list items, but inside each we have multiple sentences; still okay as
- containing multiple sentences. Requirements (minimum qualifications): - Education: Bachelor’s Degree in Healthcare Administration, Business Administration, Finance, Economics, Information Systems, or a closely related field - Experience: Four (4) years of experience in encounter data management, risk adjustment, or related field within the healthcare industry. Four (4) years of experience working with claims data to evaluate reimbursement changes, payment discrepancies, medical expense opportunities, quality outcomes and risk. We could combine as two list items. Qualifications (preferred): - Education: Master’s Degree in Healthcare Administration, Business Administration, Finance, Economics, Information Systems, or a closely related field - Experience: Five (5) years of experience in encounter data management or related field within the healthcare industry. - Strong knowledge of CMS’ Encounter Data Processing System (EDPS) data files (837P, 837I, 277CA, MAO-001, MAO-002, MAO-004) - Knowledge of ICD Diagnosis, CPT, UB, HCFA coding and understanding - Understanding of CMS Medicare Regulatory Reporting Skills: List each skill as
- .
- Strategic thinking
- Excellent written and oral communication
- Demonstrated ability to analyze complex data sets, identify patterns, and derive actionable insights.
- Familiarity with statistical analysis and machine learning techniques is a plus.
- Exceptional problem-solving and critical-thinking abilities, with a keen attention to detail.
- Ability to identify and resolve technical issues in a timely manner.
- Attention to detail
- Experience with Medicare and Medicaid products
- Working knowledge of claims, utilization management, member, and/or provider data
- Effective time management and organizational skills.
- Flexibility to adapt to changing priorities and business needs.
- Ability to thrive in a fast-paced and dynamic environment.
- Work independently as well as in a team environment
- Proficient with Microsoft Office
- Proficiency in data integration tools and techniques.
- Strong knowledge of database management systems (e.g., SQL, NoSQL), data modeling, ETL processes, and data warehousing concepts.
- Experience with data visualization and analytics tools (e.g., SAS, Tableau, Power BI) is preferred.
- Proven experience in leading technical projects.
- Strong interpersonal and communication skills to effectively collaborate with cross-functional stakeholders.
Schedule:
- Scheduled Weekly Hours: 40
- Shift: Day (United States of America)
- Exempt/Non-Exempt: Exempt (United States of America)
We could combine into one
or list. Since schedule is not a list of duties but info, we can use
. But instruction: Use
- for any list of duties/requirements/benefits. Schedule is not duties/requirements/benefits, so we can use
. We'll output a
with the schedule details. Now produce HTML fragment:
About the role
Come join Peak Health to help launch a Medicare Advantage plan. We are seeking a highly skilled and experienced professional to join our organization as an Encounters Technical Lead. Reporting to the Manager, Encounters & Risk Adjustment, the Encounters Technical Lead will play a pivotal role in our organization by overseeing the technical aspects of encounters data management and analysis. This role requires a strong understanding of healthcare encounters data, as well as expertise in data integration, data modeling, and data analytics. The successful candidate will collaborate closely with cross-functional teams to ensure accurate and efficient processing of encounters data.
Responsibilities
- Encounter Data Management: Oversee the end-to-end management of encounters data, including data ingestion, data cleansing, data transformation, and data integration. Develop and implement best practices for encounters data processing. Collaborate with internal and external stakeholders to establish effective data integration processes. Coordinate with IT teams and vendors to ensure smooth and accurate data exchange between systems and platforms. Design and develop encounter data models, ensuring they align with industry standards and organizational requirements. Optimize data models to support efficient data retrieval and analysis. Establish monitoring mechanisms to track the performance and efficiency of encounters data processes. Identify opportunities for optimization and implement appropriate measures to enhance system performance.
- Technical Leadership: Provide technical expertise and guidance in encounters data management and analysis. Set clear technical objectives and expectations, and lead by example in delivering high-quality solutions. Ability to work collaboratively across many teams, prioritize demands from those teams, synthesize information received, and generate meaningful conclusions. Develop and implement training programs to enhance the skills and knowledge of the team.
- Compliance and Reporting: Implement quality assurance processes and conduct regular audits to ensure data accuracy and integrity. Identify and resolve data-related issues promptly, collaborating with cross-functional teams as necessary. Utilize advanced analytics techniques to extract meaningful insights from encounter data. Work closely with analytics teams to define data requirements and support the development of analytical models and reports. Ensure compliance with all applicable regulatory requirements, guidelines, and contractual obligations related to Encounter Submissions (837P, 837I) and Response Files (277CA, MAO-001, MAO-002, MAO-004) via CMS’ Encounter Data Processing System (EDPS). Must possess current understanding of how compliance and quality programs such as Medicare STARS, HEDIS, and NCQA affect the Plan.
Requirements
- Education: Bachelor’s Degree in Healthcare Administration, Business Administration, Finance, Economics, Information Systems, or a closely related field
- Experience: Four (4) years of experience in encounter data management, risk adjustment, or related field within the healthcare industry. Four (4) years of experience working with claims data to evaluate reimbursement changes, payment discrepancies, medical expense opportunities, quality outcomes and risk.
Qualifications
- Education: Master’s Degree in Healthcare Administration, Business Administration, Finance, Economics, Information Systems, or a closely related field
- Experience: Five (5) years of experience in encounter data management or related field within the healthcare industry.
- Strong knowledge of CMS’ Encounter Data Processing System (EDPS) data files (837P, 837I, 277CA, MAO-001, MAO-002, MAO-004)
- Knowledge of ICD Diagnosis, CPT, UB, HCFA coding and understanding
- Understanding of CMS Medicare Regulatory Reporting
Skills
- Strategic thinking
- Excellent written and oral communication
- Demonstrated ability to analyze complex data sets, identify patterns, and derive actionable insights.
- Familiarity with statistical analysis and machine learning techniques is a plus.
- Exceptional problem-solving and critical-thinking abilities, with a keen attention to detail.
- Ability to identify and resolve technical issues in a timely manner.
- Attention to detail
- Experience with Medicare and Medicaid products
- Working knowledge of claims, utilization management, member, and/or provider data
- Effective time management and organizational skills.
- Flexibility to adapt to changing priorities and business needs.
- Ability to thrive in a fast-paced and dynamic environment.
- Work independently as well as in a team environment
- Proficient with
- for any list of duties/requirements/benefits. Schedule is not duties/requirements/benefits, so we can use