Encounter Data Management Lead

Job Description:

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. This role partners across teams to guide model performance, communicate progress, and prioritize enhancements while independently navigating complex challenges.

The Encounter Data Management Lead develops AI tools and business process to reduce/eliminate errors or automate manual steps. Monitor AI reconciliation stats to determine success of AI model. Collaborate on model changes to improve reconciliation success and collaborate on AI automation and systematic automation. Present out to partners on progress of AI modeling, errors that are on the backlog and create roadmap for backlogged work. Exercises independent on complex issues regarding job duties and related tasks, and works, uses requiring analysis of variable factors and determining the best course of action. This position reports to the Director, Encounter Data Management.

Use your skills to make an impact:

* 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.

Use your skills to make an impact

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

Additional Information
Work-At-Home Requirements
* WAH 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 25x10 (25mpbs download x 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

Interview Format
As part of our hiring process, we will be using an exciting interviewing technology provided by HireVue, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.

If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours
40

Pay RangeThe compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$94,900 - $130,500 per year

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of BenefitsHumana, 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.

Application Deadline: 05-22-2026

About us

About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.

​
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