Job Description
We are seeking a Senior Encounter & Risk Adjustment Technical Lead to 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...