Encounter Data Analyst

• Network Health’s success is rooted in its mission to create healthy and strong
• Wisconsin communities. Network Health is seeking an Encounter Data Analyst to
• support the critical encounter data functions for our Medicaid TPA line of
• business.

• This position is responsible for the identification and correction of data
• errors as well as coordinating error corrections with internal departments and
• external vendors & clients. Additionally, this role maintains compliance with
• all Department of Health Services (DHS) laws, guidance, regulations and
• standards.

• Location: Candidates must reside in the state of Wisconsin for consideration.
• This position is eligible to work at your home office (reliable internet is
• required). Travel to the corporate offices in Menasha or Brookfield will be
• required occasionally for the position, including on first day.

Hours: 1.0 FTE, 40 hours per week, 8am-5pm Monday through Friday

Check out our 2025 Community Report

• [https://www.youtube.com/watch?v=Oea3uHW0EV0] to learn a little more about the
• difference our employees make in the communities we live and work in. As an
• employee, you will have the opportunity to work hard and have fun while getting
• paid to volunteer in your local neighborhood. You too, can be part of the team
• and making a difference. Apply to this position to learn more about our team.

Job Responsibilities

• Lead the encounter data error identification effort and coordinate error

resolutions with the external vendors and clients as well as key internal

departments (i.e. claims, enrollment, provider, IT etc.)

• Act as a liaison between external vendors, clients and internal departments
• Coordinate the maintenance and enhancements for the Medicaid Encounter

Tracking System (METS) tool.

• Develop workflows and other documentation related to encounter data processes
• Remain informed and updated on industry changes e.g. DHS regulations and

changes and how they impact encounter data submissions

• Attend all DHS technical calls
• Propose innovative approaches to create or improve automation and optimize

processes.

Job Requirements

• Bachelor’s Degree in Information Technology, Health Care Information or

similar field required, or equivalent years of experience may be substituted.

• 3+ years working in a health insurance or government programs role required.
• 2+ years’ experience working as a Business Analyst or similar role required.
• Prior experience with Medicaid required. This includes working with DHS file

• submissions, 837 and 834 file submissions and health plan data including
• provider and claims processing systems.

• Experience using data to identify trends, solve problems and improve

processes.

• Must be able to analyze data to determine error sources and trends
• Understanding of database management, system design, querying and

report-writing tools.

• Intermediate/advanced skills working with Microsoft Office Suite.
• SQL skills preferred

Network Health is an Equal Opportunity Employer.