Encounter Data & Regulatory Analytics Manager

Open 46d

We’re hiring an Encounter Data & Regulatory Analytics Manager with strong SQL programming skills with the ability to query, analyze, and validate complex data sets.

Experience working with healthcare EDI transactions, specifically 837 Dental (837D) and/or 837 Professional (837P) claims, is highly preferred.

The Manager, Encounter Data & Regulatory Analytics is a hands-on technical leader responsible for overseeing encounter data submissions, regulatory reporting, and audit support across Medicaid and Medicare lines of business. This role combines leadership with deep technical execution, serving as a key partner to the AVP while ensuring compliance, accuracy, and delivery of high-impact analytics.

What You’ll Do

Regulatory Reporting & Encounter Data

Manage day-to-day execution of encounter data submissions and regulatory reporting
Serve as a subject matter expert on encounter workflows, reporting logic, and system processes
Ensure accuracy, completeness, and compliance across all regulatory deliverables

Analytics & Technical Execution

Perform hands-on SQL analysis, data validation, and complex reporting development
Translate regulatory and client requirements into actionable analytic solutions
Maintain and enhance reporting processes to ensure audit readiness and consistency

Audit & Compliance Support

Lead analytic support for regulatory audits, data validations, and examinations
Investigate data issues and provide clear, actionable resolutions
Ensure reporting processes meet audit and compliance standards

Leadership & Team Development

Lead, mentor, and develop a team of analysts responsible for reporting deliverables
Provide guidance on technical analysis and regulatory requirements
Support team prioritization and workload management

Cross-Functional Collaboration

Partner with IT, Compliance, Operations, and business stakeholders to resolve system and data issues
Support new group implementations, benefit changes, and complex client reporting
Act as a key escalation point and functional backup to the AVP

What Sets This Role Apart

Clear path to AVP-level progression with direct leadership exposure
High-impact role supporting regulatory compliance and enterprise-wide reporting
Blend of hands-on technical work and people leadership

Education & Experience

Bachelor’s degree in Information Technology, Information Science, or a related field required
6+ years of experience in healthcare analytics, encounter data, or regulatory reporting
Medicaid and/or Medicare experience required
2+ years of leadership or team management experience preferred

Core Capabilities

Advanced SQL skills with the ability to analyze and validate complex datasets
Deep knowledge of Medicaid and Medicare encounter data and reporting requirements
Strong understanding of healthcare data structures and system workflows
Proven experience supporting audits, data validation, and issue resolution
Ability to lead and mentor technical teams effectively
Strong communication skills across technical and non-technical stakeholders
Ability to prioritize and manage deadlines in a fast-paced, regulatory environment

Why Join

Opportunity to lead critical regulatory analytics in a mission-driven healthcare organization
Clear career progression into executive-level leadership
Collaborative, high-performing team with strong technical focus

Apply Today

If you’re a technical leader who thrives in complex, data-driven environments and is passionate about regulatory excellence, we encourage you to apply.

Show