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Senior Reporting & Encounters Program Manager

Location

United States

Posted

66 days ago

Salary

0

Seniority

Lead

No structured requirement data.

Job Description

Senior Reporting & Encounters Program Manager

Jobgether

Role Description This role offers a unique opportunity to lead and optimize end-to-end Medicaid reporting and encounter processes across multiple markets. You will operate at the intersection of operations, data, compliance, and client engagement, ensuring the delivery of accurate, timely, and regulatory-compliant reporting. With a strong focus on scalability and operational excellence, you will manage complex workflows, resolve cross-functional challenges, and drive continuous improvement initiatives. The position is highly collaborative and client-facing, requiring both strategic thinking and hands-on execution. You will play a critical role in supporting growth into new markets while strengthening reporting infrastructure. This is a fast-paced, impact-driven environment ideal for professionals who thrive on solving complex problems and delivering measurable outcomes. - Lead and coordinate end-to-end Medicaid reporting and encounter processes, ensuring accuracy, timeliness, and compliance with state and federal regulations. - Own the delivery of reporting outputs across multiple markets, maintaining accountability for quality and deadlines. - Act as the central liaison across Operations, Product, Business Intelligence, Finance/Claims, Compliance, Legal, and Account Management teams. - Identify, triage, and resolve reporting discrepancies, data integrity issues, and operational gaps through structured problem-solving. - Interpret CMS and state-level regulatory guidance and translate requirements into actionable workflows and processes. - Drive root cause analysis initiatives and implement scalable solutions to improve reporting performance and reliability. - Support new market launches by establishing reporting frameworks and encounter processes for new states and clients. - Enhance reporting operations through standardization, documentation, and change management best practices. - Manage dependencies, timelines, and stakeholder alignment across multiple concurrent projects. - Represent reporting functions in client interactions, including leading calls and communicating deliverables effectively. Qualifications - Bachelor’s degree or equivalent experience in healthcare, operations, managed care, or a related field. - At least 5 years of experience in Medicaid reporting, encounters, claims operations, or similar healthcare functions. - Strong knowledge of the end-to-end claims and encounter lifecycle, including submission, processing, and reporting. - Proven experience interpreting CMS regulations, state Medicaid requirements, and companion guides. - Demonstrated program or project management experience with the ability to handle multiple priorities and deadlines. - Excellent cross-functional collaboration skills, with experience aligning technical, operational, and compliance stakeholders. - Strong analytical thinking, problem-solving abilities, and clear communication skills. - Highly organized, detail-oriented, and comfortable working in ambiguous or evolving environments. - Familiarity with tools and standards such as HIPAA X12 837P, EDM platforms (e.g., Edifecs, TriZetto), and data tools like Excel, SQL, Tableau, or Looker is a plus. - Experience with multi-state Medicaid environments, audits, or healthcare service delivery models is preferred. Benefits - Competitive salary with performance-based bonus opportunities and equity options. - Remote-first work environment with flexible working hours. - Comprehensive health coverage including medical, dental, and vision insurance. - Retirement savings plan with company matching contributions. - Generous paid time off, company holidays, and parental leave. - Opportunities for career growth and professional development within a mission-driven organization. Company Description

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