Associate Vice President, Medicare & Medicaid Encounter Submissions - Remote

Overview

The Associate Vice President (AVP) of Medicare and Medicaid Encounter Submissions is responsible for the integrity, accuracy, and timeliness of submitting encounter data to Centers for Medicare and Medicaid Services (CMS) and/or Medicaid State Agencies for all Medicare, D-SNP, and Medicaid contracts.

In Short

• Lead a large-scale operation of ~220 associates focused on successful encounter data submissions.
• Ensure compliance with operational standards and requirements.
• Drive operational implementation of new Medicaid and D-SNP contracts.
• Foster collaboration with Corporate Medicaid for state expansions.
• Communicate regularly with senior leaders on operational performance.
• Identify and implement risk mitigation strategies.
• Build a culture of teamwork and accountability.
• Manage vendor relationships and contracts.
• Utilize advanced analytics and technology for operational excellence.
• Occasional travel to Humana's offices for training or meetings may be required.

Requirements

• Bachelor's degree required.
• 7+ years of management experience.
• 3+ years managing large-scale operational processes.
• Experience with process reengineering and automation.
• Strong communication skills, ability to influence senior leaders.
• Experience in claims processing and encounter submissions preferred.
• Master’s degree preferred.
• Experience managing critical vendor relationships.

Benefits

• Medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Paid time off and holidays.
• Short-term and long-term disability coverage.
• Life insurance.
• Opportunities for personal wellness and healthcare decisions.