Associate VP, Encounters Submissions

📋 Description

• • The Associate Vice President of Encounters Submissions at Humana Inc. is responsible for ensuring the integrity, accuracy, and timeliness of encounter data submissions to CMS and Medicaid State Agencies across Medicare, D-SNP, and Medicaid contracts. This role is critical to maintaining compliance, supporting rate setting, and enabling accurate reimbursement for healthcare services delivered to vulnerable populations.
• • Day to day, the AVP leads a team of approximately 220 associates, oversees operational implementation of new Medicaid and D-SNP contracts, drives enterprise-wide strategy for encounter submissions, partners with IT and analytics teams on system ownership, communicates performance and risks to senior leadership (SVP+), and fosters a culture of accountability, process improvement, and compliance.
• • The team operates within Humana’s enterprise-wide healthcare services organization, collaborating closely with Corporate Medicaid, IT leadership, business technology, analytics teams, and external vendors to optimize end-to-end encounter data processes and ensure timely escalation of operational challenges.
• • In this role, the individual will develop and execute a transformational 5-year strategy, gain deep expertise in healthcare regulatory reporting, influence enterprise-level decision-making, and build leadership capabilities in managing large-scale, high-compliance operations while driving innovation, talent development, and cost optimization.