RA Encounter Data Systems Associate Analyst
About The Position
The Risk Adjustment (RA) Associate Encounter Data Systems Analyst is an entry-level role focused on supporting the end-to-end Encounter Data Submission process across all applicable lines of business. This position plays a key role in collecting, analyzing, documenting, and reporting data to ensure compliance with state and federal requirements. As part of the Risk Adjustment Encounters team, the analyst helps manage the flow of data from multiple sources into the Encounter Data Management System through staging, transformation, and ingestion processes. Key responsibilities include routine processing of encounter data, investigating and resolving submission errors, resubmitting corrected data, and supporting software upgrades through user acceptance and unit testing. The analyst also assists in troubleshooting data and application issues, performing root cause analysis, and supporting technical integrations with upstream systems. This role requires a foundational understanding of database management, data querying, reporting, and reconciliation. The analyst contributes to mapping core health plan systems—such as claims, enrollment, pharmacy, and ancillary services—to government-mandated data outputs. Additionally, the role involves generating both routine and ad-hoc reports to monitor submission accuracy and operational efficiency across all lines of business.
Requirements
- Bachelor’s degree or equivalent in business, computer science, application programming, software development, information systems, database administration, mathematics, engineering, or a related field or equivalent relevant work experience.
Nice To Haves
- 1 year of relevant experience in an IT systems, database, analytics, or related technical environments.
Responsibilities
- Support the routine and ad-hoc creation, validation, and submission of Encounter Data files, including Enrollment, Medical Claims, Pharmacy, and Chart Review data, in accordance with regulatory requirements.
- Assists with root cause analysis on encounter data held for internal edits or rejected by external entities; collaborate with fellow analysts and cross-functional teams to resolve issues and ensure timely resubmission.
- Document upstream business processes that influence encounter data inputs, identifying system dependencies and potential data quality risks.
- Maintain comprehensive documentation of the Encounter Data Submission lifecycle, including internal edit logic, update protocols, and explainable variances that impact final reconciliation and compliance reporting.
- Assist in the development of operational reports and reconciliation tools to track encounter data across all stages—input sources, data batches, file submissions, and response files
- Contribute to the design and delivery of dashboards and executive‑level reporting to communicate key encounter data metrics and performance indicators to senior leadership
- Ensure data accuracy and integrity through detailed analysis, reconciliation, clear documentation, and proactive issue resolution.
- Support the design, development, and execution of ad-hoc reports and data analyses using SQL and other analytical tools; validate and publish metrics to assess operational effectiveness and compliance.
- Actively participates in safety initiatives and risk mitigating measures where appropriate and completes all position and unit safety related competencies and requirements on a timely basis.
- Perform other duties as assigned.
Benefits
- Comprehensive benefits package to meet your financial, health, and work/life balance goals. Learn more here.
- On-demand pay program powered by Payactiv
- Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more!
- Optional identity theft protection, home and auto insurance, pet insurance
- Traditional and Roth retirement options with service contribution and match savings
- Eligibility for benefits is determined by employment type and status
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Number of Employees
5,001-10,000 employees
