Manager, Clinical Data Management

Aledade, Inc.

. Oversee the end-to-end strategy, priorities, and operations for accurate and compliant encounter data submission to payers and CMS .

Posted 11/6/2026full-timeRemote • United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in encounter data submission processes, compliance with regulatory standards, and effective project management. Proficient in data analysis, reporting, and collaboration with cross-functional teams to optimize workflows and improve financial performance.

Highest-signal resume keywords

Encounter Data SubmissionMedicare Advantage ExperienceProject ManagementSQL ProficiencyAnalytical Capabilities

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

X12 837 Transaction SetsCMS EDPS ExperienceData AnalysisBusiness Process ReengineeringChart Selection StrategiesRelational DatabasesFinancial Performance Optimization

Soft Skills

Excellent Communication SkillsLeadership CollaborationAnalytical Thinking

Tools & Technologies

Google WorkspaceJiraSmartsheetBusiness Intelligence Platforms

Industry Keywords

Value Based CareRisk AdjustmentPayer ComplianceEncounter Data Processes

Tech Stack

Tools & technologies

AssemblySQL

About the role

Key responsibilities & impact

Oversee the end-to-end strategy, priorities, and operations for accurate and compliant encounter data submission to payers and CMS
Create and transmit ASM files on established cadences, maintaining payer-specific templates and submission methods annually
Establish reconciliation processes to track diagnoses from documentation to acceptance, quantify gaps, and identify dropped or truncated records
Lead root-cause analysis and corrective action across internal teams, vendors, and payers for rejected or dropped diagnoses
Partner with operations leadership on strategy, chart selection, and annual evaluation for retrospective chart review
Monitor submission metrics and acceptance rates, applying data scrubs and business rules to meet regulatory standards and CMS/payer deadlines
Collaborate with leadership and legal partners to ensure compliance with add and delete diagnosis workflows
Develop and maintain process documentation, SOPs, and routine workflow updates
Identify tools and long-term strategies to improve encounter acceptance rates, minimize manual effort, and expand ASM processes across eligible payers
Evaluate annual ROI across submission and audit processes and optimize workflows to drive financial performance
Lead cross-functional initiatives to resolve data flow issues and implement system updates
Integrate accepted ASM-submitted diagnosis data into existing risk reporting dashboards and build recurring reports for leadership
Own ASM valuation and financial results, partnering with Data and Analytics on metric definitions and data quality

Requirements

What you’ll need

Bachelor’s degree in Business, Finance, IT, Healthcare Analytics, or Operations
6+ years of experience with Medicare Advantage or ACA encounter data processes, and/or risk adjustment experience within a payer, vendor, or Value Based Care organization
3+ years of program or project management experience, including ownership of complex, multi-stakeholder initiatives
2+ years of working knowledge with X12 837 transaction sets
Working knowledge of CMS EDPS experience (MAO-002/MAO-004 reports)
Strong analytical capabilities with the ability to interpret complex datasets and synthesize actionable insights
Excellent written and verbal communication skills, with experience developing and presenting key information to executive leadership
Working knowledge of SQL, including writing, modifying, and executing queries
Proficiency in Google Workspace, project tracking software such as Jira or Smartsheet, and business intelligence or dashboard platforms
Familiarity with Business Process Reengineering principles and methodologies
Experience with chart selection or targeting strategies for retrospective chart review
Fundamental understanding of relational databases
Prolonged periods of sitting at a desk and working on a computer

Benefits

Comp & perks

Flexible work schedules and the ability to work remotely are available for many roles
Health, dental and vision insurance paid up to 80% for employees, dependents and domestic partners
21 days of PTO in the first year
Two paid volunteer days
11 paid holidays
12 weeks paid parental leave for all new parents
Six weeks paid sabbatical after six years of service
Educational Assistant Program
Clinical Employee Reimbursement Program
401(k) with up to 4% match
Stock options