{"id":1262979,"url":"https://alion.io/job/caresource-encounters-systems-analyst-ii","title":"Encounters Systems Analyst II","company":{"id":2670646,"name":"CareSource","domain":"caresource.com","url":"https://alion.io/company/caresource","size_band":null,"is_staffing_agency":false,"employer_type":"direct","is_intermediary":false,"listed_via":null,"ats_vendor":"Schema","truth_index":null},"role":"Analytics","role_family":"Analytics","seniority":"middle","employment_type":"full_time","work_mode":"on_site","remote_scope":null,"remote_scope_basis":null,"remote_working_hours":null,"hiring_geo_confidence":"structured","locations":[],"countries":[],"hiring_countries":[],"hiring_countries_total":0,"salary":{"min":62700,"max":100400,"currency":"USD","period":"year","gross":null,"usd_annual":100400},"salary_estimate":null,"experience_years_min":1,"visa_sponsorship":false,"relocation_package":false,"has_equity":false,"technologies":[{"name":"Agile","optional":false},{"name":"MySQL","optional":false},{"name":"Power BI","optional":false},{"name":"SAS","optional":false},{"name":"SLI/SLO/SLA","optional":false},{"name":"SQL","optional":false},{"name":"SSIS","optional":false}],"status":"live","first_seen_at":"2026-09-25T21:15:17Z","employer_posted_date":"2026-09-25","last_verified_at":"2026-09-29T00:37:09Z","board_verified":true,"closed_at":null,"days_open":3,"trust":{"level":"ok","repost_count":null,"flags":[],"days_open":3},"description":"Job Summary:\nThe Encounters Systems Analyst II is responsible for performing analysis of Encounters data and understanding the financial and clinical impact of changes and decisions to the business process to ensure that the Service Level Agreements are achieved.\nEssential Functions:\nPerform analysis of Encounter data. Understand the financial and clinical impact of changes and decisions to the business process to ensure that the Service Level Agreements (SLAs) are achieved\nSupport for Regulatory Data projects\nResponsible for reviewing Encounter rejections and providing resolution of minor to complex data issues or process changes \n Support for Claims Encounter Subject Matter Expertise (SME) for both CMS and State agencies and internal CareSource impacted organizations (IT, Claims, New Business, Enrollment, etc.) \nBuild, sustain and leverage relationships with persons within his/her area of responsibility to allow for continuous improvement of the Encounter Data business process \n Support for testing and delivering process to business.\n Participate in claims data processes to ensure accuracy and compliance with CMS and state agencies\n Participate in the key claims data management and readiness to state and governing entities\nUnderstand the Claims Encounter Data requirements in detail to enable one to support efforts to ensure claims data submissions achieve the required SLAs through requested changes internally and externally \nRecognize inconsistencies and gaps to improve productivity, accuracy and data usability and streamlining procedures and policies\n Support Claims Encounters regulatory reporting\n Support for critical reporting and analysis of functional performance, and make recommendations for enhancements, cost savings initiatives and process improvements\nMonitor various management and oversight metrics and reports as required\n Support Claims Encounter initiatives such as working with IT and others internal departments to automate Claims Encounters functions; improve regulatory report development with reporting department\nProvide support of vendors, managing SLA’s, regulatory requirements and contractual metrics\nMaintain positive and strategic relationships with internal and external stakeholders\nContribute to and/or develop user stories or provide user story guidance for sprint planning\nUnderstanding of how claims payment methodologies, adjudication processing and State Encounter regulations interrelate to maintain compliant Encounter reconciliation processes and SLA’s\nPerform any other job duties as requested\nEducation and Experience:\nBachelor’s degree in Science/Arts or equivalent years of relevant work is required\nMaster’s Degree in Science/Arts is preferred; concentration in Healthcare Analytics or Data Science preferred\nMinimum of one (1) year to two (2) years of managed healthcare, claims, or managed care regulated environment experience is required\nMinimum of one (1) year of experience using at least two of the following tools is required: SQL, SAS, SSIS. MySQL, ORACLE, R, or PowerBI\nCompetencies, Knowledge and Skills:\nIntermediate computer skills, Advanced skills in Excel \nEdifecs knowledge is preferred\nData analysis and trending skills\nDemonstrated understanding of claims operations specifically related to encounters\nAdvanced knowledge of coding and billing processes, including CPT, ICD-9, ICD-10 and HCPCS coding\nKnowledge of Claims IT processes/systems and analytic processes\nKnowledge of Agile is preferred\nKnowledge of Facets is preferred\nExperience in Documentation of business requirements\nAdvanced working knowledge of managed care and health claims processing and reimbursement methodologies\nExperience with 837O files to States and/or CMS (MA EDS) preferred\nExperience with 835 files preferred\nExcellent communication skills; both written and verbal required\nAbility to work independently and within a team environment\nTime management skills; capable of multi-tasking and prioritizing work\nAttention to detail\nEffective decision making / problem solving skills\nCritical thinking and listening skills\nLicensure and Certification:\nNone\nWorking Conditions:\nGeneral office environment; may be required to sit or stand for extended periods of time\n$62,700.00 - $100,400.00 CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.\nSalary\nOrganization Level Competencies\n- Fostering a Collaborative Workplace Culture\n- Cultivate Partnerships\n- Develop Self and Others\n- Drive Execution\n- Influence Others\n- Pursue Personal Excellence\n- Understand the Business\nThis job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.\n#LI-EM1","description_format":"text","description_chars":5272,"description_truncated":false,"requirements":{"experience_years_min":1,"management_years_min":null,"team_size_min":null,"manages_managers":false,"education":{"level":"bachelor","optional":true},"security_clearance":false,"languages":[]},"benefits":[],"hiring_locations":[],"hiring_excludes":[],"relocation_offered":false,"industries":[],"lifecycle":[{"event":"open","at":"2026-09-25T21:15:17Z"}],"liveness":{"score":84,"band":"hot","label":"Hiring now","p_open":1,"p_active":0.841,"p_room":1,"age_days":2,"expected_fill_days":10,"reasons":["conf:7","velocity","win:early"],"computed_at":"2026-09-28T05:45:00Z"},"pay":{"stated_usd_annual":100400,"is_top_pay":true},"html_url":"https://alion.io/job/caresource-encounters-systems-analyst-ii","json_url":"https://alion.io/job/caresource-encounters-systems-analyst-ii.json","meta":{"generated_at":"2026-09-29T00:52:59Z","cache_seconds":300,"methodology":"https://alion.io/methodology","terms":"https://alion.io/terms","contact":"https://alion.io/contact","api":"https://alion.io/developers","usage":{"tier":"crawler","counted_by":"address","units_charged":1,"used_today":792,"day_limit":5000,"remaining_today":4208,"minute_limit":60,"resets_at":"2026-09-30T00:00:00Z"}}}