Clinical Data Management Manager

Job Summary

Leading the Encounter Data Submission and Reconciliation strategy, the full-time Manager, Clinical Data Management will oversee the lifecycle of data submission to payers and CMS, ensuring accuracy and compliance while collaborating with internal teams and external partners in a remote setting.

Key Responsibilities

• Oversee the end-to-end strategy and operations for encounter data submission and reconciliation
• Monitor submission metrics and compliance with regulatory standards, developing process documentation and SOPs
• Identify and implement process improvements to enhance encounter acceptance rates and optimize workflows

Required Qualifications

• Bachelor's degree in Business, Finance, IT, Healthcare Analytics, or Operations
• 6+ years of experience with Medicare Advantage or ACA encounter data processes
• 3+ years of program or project management experience with multi-stakeholder initiatives
• 2+ years of experience with X12 837 transaction sets and CMS EDPS reports
• Strong analytical skills with the ability to interpret complex datasets and provide actionable insights