Priority Health · 3 hours ago
RA Encounter Data System Senior Analyst
Grand Rapids, MI
Full-time
Onsite
Mid, Senior Level
3+ years expPriority Health is a health system that focuses on equitable care for its patients and communities. They are seeking a Risk Adjustment Senior Encounter Data Systems Analyst who will manage and enhance the Encounter Data Submission process while ensuring compliance with regulatory requirements and improving data quality.
Health Care
Responsibilities
Serves as the business product owner for the Encounter Data Submission system, overseeing the routine and ad-hoc creation and submission of encounter data across all domains, including Enrollment, Medical Claims, Pharmacy, and Chart Review
Leads comprehensive reconciliation efforts and root cause analysis for data system issues and submission incidents, including internal and external (government) edit rejections
Manages relationships with cross-functional teams to ensure accurate and timely resolution of Encounter Data Submission issues; reviews and updates documentation for upstream business processes that impact data inputs
Acts as Encounters Subject Matter Expert with the Encounter Data Submission system IT vendor, reviewing incident reports, contributing to backlog refinement, and supporting release management activities
Designs and develops operational reports to support full-cycle reconciliation of encounter data, including source inputs, data batches, file submissions, and response files. Creates dashboards and executive-level reporting to communicate key encounter data metrics and performance indicators to senior leadership
Plans, tests, and supports ETL processes, including the design of table structures and data workflows to support encounter data ingestion and transformation
Identifies and assesses the impact of incidents within the core Encounter Data Submission system; collaborates with IT vendors to refine backlog items and implement new market or regulatory submission requirements. Supports system integration efforts by leading data validation, testing, and implementation of new functionality or submission requirements
Troubleshoots and resolves production issues related to encounter data and supporting applications, ensuring minimal disruption to submission processes. Evaluates and advises on short-term workaround strategies to address Encounter Data Submission issues while long-term solutions are developed
Qualification
Required
Bachelor's Degree or equivalent in business, liberal arts, computer science, application programming, software development, information systems, database administration, mathematics, engineering, or other related field, or equivalent work experience
3 years of relevant experience in the Encounter Data Processing of outbound and response transaction: State 837, Edge XML, CMS EDPS 837, MMP, etc field or
5 years of relevant experience IT systems, databases, analytics, or related encounter data submission and resolution experience. Preferably with large, complex data sources
Benefits
Comprehensive benefits package to meet your financial, health, and work/life balance goals.
On-demand pay program powered by Payactiv
Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more!
Optional identity theft protection, home and auto insurance, pet insurance
Traditional and Roth retirement options with service contribution and match savings
Company
Priority Health
Priority Health is an award-winning health benefits company.
1001-5000 employees
H1B Sponsorship
Priority Health has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (6)
2024 (9)
2023 (9)
2022 (10)
2021 (5)
2020 (8)
Funding
Current Stage
Late StageTotal Funding
$0.5MKey Investors
Michigan Health Endowment Fund
2022-02-24Grant· $0.5M
Leadership Team
Nick Gates
President
Recent News
2025-12-11
Morningstar.com
2025-11-18
Company data provided by crunchbase