Encounter Data & Regulatory Analytics Manager

Posted Yesterday
Be an Early Applicant
Hiring Remotely in Irvine, CA, USA
In-Office or Remote
116K-144K Annually
Senior level
Healthtech • Insurance
The Role
Lead and execute encounter data submissions and regulatory reporting for Medicaid/Medicare. Perform hands-on SQL analysis, data validation, and audit support. Translate regulatory requirements into analytic solutions, mentor analysts, collaborate with IT/compliance/operations, and ensure accuracy, compliance, and readiness for regulatory examinations.
Summary Generated by Built In

 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.

Qualifications

Location

Our employees are based across multiple office locations throughout the United States. At this time, we are unable to hire employees or support work arrangements outside of the United States.

What Liberty Offers

At Liberty, we believe happy, healthy employees are better equipped to serve our members and make meaningful contributions to their communities. That’s why we offer a competitive and comprehensive benefits package designed to support employee well-being and productivity.

We offer a first-class benefits package that includes:
 

  • Comprehensive medical coverage through Anthem, with affordable premiums and multiple plan options - including an HDHP with HSA eligibility.
  • 100% employer-paid dental insurance and low-cost vision coverage for employees and dependents.
  • 401(k) retirement plan with immediate vesting, employer match, Roth option, and access to professional financial advice.
  • Short-term disability and a variety of voluntary benefits, including accident, critical illness, and hospital indemnity insurance.
  • Generous paid time off, including vacation and sick leave with rollover options, plus 10 paid company holidays and a wellness day.
  • Additional benefits including company-paid life insurance, tuition reimbursement, an employee perks program, and flexible work options for eligible positions.

Compensation

In the spirit of pay transparency, the base salary range for this position is $115,595 - $144,494/annual, excluding benefits and potential bonuses. Final compensation will be determined based on factors such as geographic location, experience, skills, and education. Liberty is committed to pay equity and also considers internal equity among current employees when making compensation decisions.

Please note that offers are typically not made at the top of the salary range, allowing for future growth and advancement.

Our Commitment

Liberty Dental Plan is dedicated to fostering a workplace where all individuals feel valued, respected, and empowered. We are committed to building an inclusive environment that embraces diverse backgrounds, experiences, and perspectives, while creating a strong sense of belonging across our organization.

We also remain focused on strengthening external partnerships to ensure equitable access to healthcare and improve population health in the communities we serve.

Liberty complies with all applicable laws and regulations related to non-discrimination in employment, recruitment, promotions, transfers, and work authorization requirements.

Sponsorship and Relocation

Liberty Dental Plan is an Equal Opportunity Employer (including VETS and individuals with disabilities).

At this time, we do not offer relocation assistance or employment sponsorship.

Skills Required

  • Bachelor's degree in Information Technology, Information Science, or related field
  • 6+ years experience in healthcare analytics, encounter data, or regulatory reporting
  • Medicaid and/or Medicare experience
  • 2+ years of leadership or team management experience
  • Advanced SQL skills with ability to analyze and validate complex datasets
  • Deep knowledge of Medicaid and Medicare encounter data and reporting requirements
  • Experience with healthcare EDI transactions (837D and/or 837P)
  • Proven experience supporting audits, data validation, and issue resolution
  • Strong understanding of healthcare data structures and system workflows
  • Strong communication skills across technical and non-technical stakeholders
  • Ability to prioritize and manage deadlines in a fast-paced, regulatory environment
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The Company
HQ: Irvine, CA
1,021 Employees
Year Founded: 2002

What We Do

LIBERTY Dental Plan is a dental benefits administrator founded by dentists and health industry professionals in 2002. It administers dental benefits for millions of members across all 50 states, focusing on quality, innovation, and affordability to improve oral health outcomes.

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