Find & Apply For Clinical Analyst / Clinical Documentation and Improvement Specialist Jobs in Newtown, Pennsylvania

Insight Global Keyword Location Search view all jobs Senior Healthcare Data Integration Engineer Newtown, PA Posted 48 days ago Apply Now Job Description We are seeking a Senior Healthcare Data Integration Engineer to work on the Exchange Encounter & Risk Adjustment team. This person will support healthcare payer operations focused on ACA Exchange Risk Adjustment, CMS EDGE submissions, encounter data quality, and healthcare data integration. This is a hands-on technical leadership role responsible for troubleshooting complex healthcare data issues, improving encounter data quality, supporting

CMS EDGE

processes, and partnering across business, IT, data, and vendor teams. This is not a project management role.

•  Lead technical troubleshooting of encounter and risk adjustment data issues
•  Analyze

CMS EDGE

submission errors and drive resolution

•  Support encounter reconciliation, validation, and error remediation activities
•  Partner with business, operations, data, IT, and vendor teams
•  Improve encounter acceptance rates and overall data quality
•  Translate CMS and business requirements into technical solutions
•  Provide technical guidance to developers and analysts We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day.

We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.

To learn more about how we collect, keep, and process your private information, please review

Insight Global's Workforce Privacy Policy:

https://insightglobal.com/workforce-privacy-policy/. Skills and Requirements

• Strong experience with SSIS, ETL, and C#
• Healthcare background, specifically with CMS/Medicare/Medicaid
• Strong understanding of healthcare payer data, including: o Claims o Encounters o Enrollment o Diagnosis data
•  Advanced SQL skills for data analysis, validation, and troubleshooting
•  Experience with healthcare EDI transactions
•  Experience with healthcare integration platforms such as: o Edifecs o IBM ITX (Transformation Extender) o Similar healthcare EDI/integration tools
•  Proven ability to troubleshoot complex healthcare data pipelines and submission issues
•  HHS-HCC Risk Adjustment experience
• Direct experience supporting ACA Exchange Risk Adjustment
• Hands-on experience with

CMS EDGE

Server submissions, reconciliation, validation, and error remediation

•  Encounter acceptance/rejection analysis
•  CMS audit support
•  Data quality improvement initiatives
•  Healthcare data warehouse or data lake environments
•  Databricks or cloud-based healthcare data platforms
•  Technical leadership or mentoring experience
•  Vendor management experience Apply Now Active Filters Senior Healthcare Data.

.. Newtown, PA Clear All Powered By Cookie Policy We use cookies to improve your experience on our site. To find out more, read our privacy policy Accept Cookies Decline Cookies