Encounter Data Manager (edm) - Facets

Huron

United States
Fully remote
5+ years healthcare payer experience
Facets (trizetto) configuration expertise
837/835 edi transaction processing
Huron is seeking a highly experienced Encounter Data Manager (EDM) with expertise in Facets configuration and claims management to support healthcare payer clients. This fully remote position requires a strong background in encounter data lifecycle management, including compliance with CMS and Medicaid regulations, as well as hands-on experience with EDI processing and claims adjudication

Job Summary

  • This role supports healthcare payer clients by managing the end-to-end lifecycle of encounter data to ensure regulatory compliance and financial accuracy.
  • The successful candidate will configure and validate Facets components while troubleshooting complex data issues impacting claims processing and submissions.
  • Joining this global consultancy team offers the opportunity to drive performance transformation and optimize business operations for health systems and hospitals.

Matching Summary

Match Score: 85

Huron is seeking a highly experienced Encounter Data Manager (EDM) with expertise in Facets configuration and claims management to support healthcare payer clients. This fully remote position requires a strong background in encounter data lifecycle management, including compliance with CMS and Medicaid regulations, as well as hands-on experience with EDI processing and claims adjudication.

Skills & Requirements

Must-have

  • 5+ years healthcare payer experience
  • Facets (TriZetto) configuration expertise
  • 837/835 EDI transaction processing
  • CMS and state Medicaid regulatory compliance
  • Claims adjudication logic alignment

Nice-to-have

  • Risk adjustment background
  • Revenue cycle management experience
  • Payment integrity knowledge
  • Consulting or client-facing environment
  • Workflow automation implementation

Key Requirements

  • 5+ years hands-on experience with Facets EDM
  • Proven ability to interpret CMS requirements
  • Experience working in consulting environments
  • Strong communication with technical staff

Work Rights

Not specified

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