Encounters Technical Lead

WVU Medicine

. Oversee end-to-end encounters data management, including ingestion, cleansing, transformation, and integration .

Posted 9/22/2026full-timeRemote • United StatesSeniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in encounters data management, including ingestion, cleansing, transformation, and integration, while ensuring compliance with regulatory requirements. Proficient in data analysis and integration tools, with a strong ability to lead technical projects and collaborate across teams.

Highest-signal resume keywords

Encounter Data ManagementData Integration ToolsSQL Database ManagementMedicare and Medicaid KnowledgeData Modeling and ETL Processes

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Data CleansingData TransformationData IntegrationDatabase Management SystemsAdvanced AnalyticsData Warehousing ConceptsClaims Data EvaluationRisk AdjustmentTechnical Project LeadershipQuality Assurance Processes

Soft Skills

Interpersonal SkillsCommunication SkillsCollaborationProblem-SolvingIndependent Work

Tools & Technologies

Microsoft OfficeSASTableauPower BI

Industry Keywords

Healthcare AdministrationCMS Encounter SubmissionsICD Diagnosis CodingCPT CodingUB CodingHEDISNCQAMedicare STARS

Tech Stack

Tools & technologies

ETLNoSQLSQLTableau

About the role

Key responsibilities & impact

Oversee end-to-end encounters data management, including ingestion, cleansing, transformation, and integration
Develop and implement best practices for encounters data processing
Establish data integration processes with internal and external stakeholders
Coordinate with IT teams and vendors to ensure accurate data exchange between systems and platforms
Design, develop, and optimize encounter data models
Monitor encounters data process performance and implement optimization measures
Provide technical expertise and guidance in encounters data management and analysis
Set technical objectives and expectations and lead delivery of high-quality solutions
Collaborate across teams, prioritize demands, synthesize information, and generate meaningful conclusions
Develop and implement team training programs
Implement quality assurance processes and conduct regular audits for data accuracy and integrity
Identify and resolve data-related issues with cross-functional teams
Use advanced analytics to extract insights from encounter data
Support analytics teams with data requirements, analytical models, and reports
Ensure compliance with regulatory requirements, guidelines, and contractual obligations for CMS encounter submissions and response files
Work on a computer in a remote environment

Requirements

What you’ll need

Bachelor’s Degree in Healthcare Administration, Business Administration, Finance, Economics, Information Systems, or a closely related field
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
Experience with Medicare and Medicaid products
Working knowledge of claims, utilization management, member, and/or provider data
Proficient with Microsoft Office
Proficiency in data integration tools and techniques
Strong knowledge of database management systems, including SQL and NoSQL
Knowledge of data modeling, ETL processes, and data warehousing concepts
Proven experience in leading technical projects
Ability to analyze complex data sets, identify patterns, and derive actionable insights
Ability to identify and resolve technical issues in a timely manner
Strong interpersonal and communication skills to collaborate with cross-functional stakeholders
Ability to work independently and in a team environment
Preferred: Master’s Degree; five (5) years of encounter data management experience; knowledge of CMS EDPS data files; ICD Diagnosis, CPT, UB, and HCFA coding; CMS Medicare Regulatory Reporting; SAS, Tableau, or Power BI
Must possess current understanding of how Medicare STARS, HEDIS, and NCQA affect the Plan

Benefits

Comp & perks

Full-time position
Remote work environment