{"id":109680,"url":"https://alion.io/job/veradigm-systems-analyst-payer-encounter-management-platform","title":"Systems Analyst - Payer Encounter Management Platform","company":{"id":3132,"name":"Veradigm","domain":"veradigm.com","url":"https://alion.io/company/allscripts","size_band":"1001-5000","is_staffing_agency":false,"employer_type":"direct","is_intermediary":false,"listed_via":null,"ats_vendor":"Workday","truth_index":{"grade":"A","score":86,"open_postings":11,"ghost_share":0,"stale_share":0.545,"repost_share":0,"time_to_fill_p50_days":43,"computed_at":"2026-10-26T05:57:25Z"}},"role":"Analytics","role_family":"Analytics","seniority":"junior","employment_type":"full_time","work_mode":"hybrid","remote_scope":null,"remote_scope_basis":null,"remote_working_hours":null,"hiring_geo_confidence":"explicit","locations":["Raleigh, United States"],"countries":["US"],"hiring_countries":[],"hiring_countries_total":0,"salary":{"min":69852,"max":97094,"currency":"USD","period":"year","gross":null,"usd_annual":97094},"salary_estimate":null,"experience_years_min":2,"visa_sponsorship":true,"relocation_package":false,"has_equity":false,"technologies":[{"name":"HIPAA","optional":false},{"name":"SQL","optional":false}],"status":"live","first_seen_at":"2026-03-30T00:00:00Z","employer_posted_date":"2026-03-30","last_verified_at":"2026-10-26T14:55:19Z","board_verified":true,"closed_at":null,"days_open":210,"trust":{"level":"stale","repost_count":0,"flags":["stale"],"days_open":210},"description":"Veradigm is a healthcare analytics and technology company that helps health plans and at-risk providers improve Risk Adjustment and Quality outcomes across HIX, Medicare Advantage, and Medicaid. With advanced analytics and real-time intelligence, we give clients clear visibility into member and provider activity so they can close documentation, coding, and quality gaps more efficiently.\nThe Veradigm Encounter Management Platform is a centralized solution that processes, validates, and submits encounter and supplemental data for Medicare, Medicaid, ACA, and other government programs. It streamlines ingestion, edit resolution, submission readiness, and CMS response handling, giving health plans and BPO partners a reliable, compliant way to manage large-scale encounter operations.\nJob Summary\nThe Systems Analyst works primarily with enterprise customers of Veradigm’s Encounter Management Platform, proactively assisting them with post- sales installation, configuration, upgrade, troubleshooting and day to day operational management. Responsibilities include taking a proactive leadership role working with the Engineering team and Customers to triage and resolve highly complex, technical, and application-related issues which impact product performance in customer-specific environments, or issues that directly hamper a broader customer adoption of Veradigm’s Encounter Management Platform. In addition to working with customers, the Systems Analyst will routinely partner with our Development, Sustaining Engineering and Sales Engineering organizations to resolve support issues, document bugs, provide UAT on product builds, and ensure that new and newly upgraded server installations are successful.\nWhat you will contribute:\nSupport encounter data reporting processes for EDPS, RAPS and the EDGE server, including tracking, reporting, and resolving rejections\nConduct gap analysis and data validation, identifying possible issues in data submission and determining financial impact.\nAnalyze and reconcile claims and encounter data which will include 837 EDI encounter files for EDPS, RAPS and Edge Server submission files\nPerform research in the encounter management system and liaison with the CSSC Helpdesk for exception resolution\nBe comfortable with raw data files in their native format and accessing these through various servers\nPartner with Product Support Engineers and development teams as necessary\nAssist development team with performance analysis and testing during release cycles for service packs, hot fixes etc\nAnswer email and phone requests for help from customers\nCollaborate in virtual teamwork with other Product Support staff\nHost online troubleshooting and investigation sessions on customer’s production environments\nDeliver a consistent, responsive and satisfying customer experience with each contact\nCollect all necessary problem details from customers to be able to effectively see the problem to resolution\nSuccessfully reproduce customer issues in a controlled test environment\nFollow standard operational procedures for case management\nContinuously improve troubleshooting skills, product expertise, and knowledge on related technical topics\nPerform ACA and MA Submissions for Clients\nUnderstand RAPS and EDPS filtering logic which CMS uses for Risk Adjustment and/or Risk Score calculations\nMonitor CMS data submission deadlines for both MA and ACA lines of business\nThe ideal candidate will have:\nAcademic and Professional Qualifications:\n· Bachelor’s Degree in Health IT/Informatics/Management Information Systems or related field required\nExperience:\n2+ years of professional experience in Risk Adjustment data management\nUnderstanding of claims data, encounter response files, 837 EDI encounter files, EDGE/MA billing & business rules as well as MA filtering logic for EDPS\nExperience with CMS Submissions Process and EDI transactions\nExcellent time management and organizational skills necessary\nPrior experience troubleshooting performance problems that may have many underlying causes such as Disk, Database, Network, Messaging and other platform / 3rd party solutions\nExperience with managing product back end and webservices\nAbility to guide customers remotely through complex, multi-server deployments and upgrades for enterprise products\nFamiliarity with EDI Standards such as X12, EDIFACT, HL7, NCPDP and knowledge of HIPAA transactions\nPrior knowledge of 837’s along with various loops and segments and an understanding of the requirements set forth by CMS for EDPS submission files\nWorking knowledge in SQL scripts is a plus\nGood written and verbal skills.\nKnowledge in CMS model changes is a plus\nKnowledge in CMS Risk Score and Risk Adjustment methodologies is a plus\nKnowledge in Medicaid is a plus\nTravel Requirements:\nLess than 5%\nCompensation Range:\n$69,852-$97,094Compensation for this job is subject to market conditions, geographic considerations, the candidate’s unique skills and experience, state and local laws, and budget. Our commitment to pay transparency is a testament to our dedication to creating a fair, equitable, and inclusive workplace. By continuously analyzing market trends, staying abreast of changes in state laws, and making budgetary adjustments accordingly, we strive to ensure that our compensation practices reflect the value we place on our associates’ unique contributions and support their professional growth.\nEnhancing Lives and Building Careers\nVeradigm believes in empowering our associates with the tools and flexibility to bring the best version of themselves to work and to further their professional development. Together, we are In the Network. Interested in learning more?\nTake a look at our Culture, Benefits, Early Talent Program, and Additional Openings.\nWe strongly advocate that our associates receive all CDC recommended vaccinations in prevention of COVID-19.\nVisa Sponsorship is not offered for this position.\nAt Veradigm, our greatest strength comes from bringing together talented people with diverse perspectives to support the needs of healthcare providers, life science companies, health plans, and the patients they serve. The Veradigm Network is a dynamic, open community of solutions, external partners, and cutting-edge artificial intelligence technologies that provide advanced insights, technology, and data-driven solutions. Veradigm offers a comprehensive compensation and benefits package, including holidays, vacation, medical, dental, and vision insurance, company paid life insurance and retirement savings.\nVeradigm’s policy is to provide equal employment opportunity and affirmative action in all of its employment practices without regard to race, color, religion, sex, national origin, ancestry, marital status, protected veteran status, age, individuals with disabilities, sexual orientation or gender identity or expression or any other legally protected category. Applicants for North American based positions with Veradigm must be legally authorized to work in the United States or Canada. Verification of employment eligibility will be required as a condition of hire. Veradigm is proud to be an equal opportunity workplace dedicated to pursuing and hiring a diverse and inclusive workforce.\nFrom a \"VEVRAA Federal Contractor\" We request Priority Referral of Protected Veterans\nThis is an official Veradigm Job posting. To avoid identity theft, please only consider applying to jobs posted on our official corporate site.\nThank you for reviewing this Veradigm opportunity. Does this look like a great match for your skill set? If so, scroll on down and tell us more about yourself!","description_format":"text","description_chars":7626,"description_truncated":false,"requirements":{"experience_years_min":2,"management_years_min":null,"team_size_min":null,"manages_managers":false,"education":{"level":"bachelor","optional":false},"security_clearance":false,"languages":[]},"benefits":["Life insurance","Professional development","Vision insurance"],"hiring_locations":[{"name":"United States","iso":"US","kind":"country"},{"name":"Canada","iso":"CA","kind":"country"}],"hiring_excludes":[],"relocation_offered":false,"industries":["EHR & Clinical Software","Practice Management Software","Health Data & Interoperability"],"lifecycle":[{"event":"open","at":"2026-03-30T00:00:00Z"}],"visa":[{"country":"US","licensed_sponsor":true,"evidence":"H-1B filings in 12 months: 15 · green card filings: 6","filings_12m":15,"filings_prev_12m":11,"green_card_filings_12m":6,"median_offered_wage_usd":128929,"route":null,"cap_exempt":false,"checked_at":"2026-10-15T11:24:14+00:00","sources":["US Department of Labor: LCA disclosure data (H-1B, H-1B1, E-3)","US Department of Labor: PERM disclosure data (green cards)"],"filings_for_role_12m":0}],"liveness":{"score":3,"band":"cold","label":"Long shot","p_open":0.9,"p_active":0.129,"p_room":0.28,"age_days":210,"expected_fill_days":43,"reasons":["conf:70","stale_co","velocity","win:tail","crowd:junior"],"computed_at":"2026-10-26T05:57:25Z"},"pay":{"stated_usd_annual":97094,"is_top_pay":true},"html_url":"https://alion.io/job/veradigm-systems-analyst-payer-encounter-management-platform","json_url":"https://alion.io/job/veradigm-systems-analyst-payer-encounter-management-platform.json","meta":{"generated_at":"2026-10-26T15:17:12Z","cache_seconds":300,"methodology":"https://alion.io/methodology","terms":"https://alion.io/terms","contact":"https://alion.io/contact","api":"https://alion.io/developers","about":"Alion is a live layer of people, companies and AI agents: who they are, whether they are real and active right now, what they do and how to work with them, readable by people and by agents and paid per call.","catalog":"https://alion.io/catalog.json","usage":{"tier":"crawler_verified","counted_by":"address","units_charged":1,"used_today":20292,"day_limit":null,"remaining_today":null,"minute_limit":300,"resets_at":"2026-10-27T00:00:00Z"}},"offers":[{"id":"company.slices","title":"One company in depth, by slice","status":"live","price":{"credits":0.02,"usd":0.002,"plus_per_slice":{"credits":0.05,"usd":0.005}},"unit":"per company, plus each slice with data","note":"the employer in depth","call":{"mcp_tool":"get_company","arguments":{"id":3132},"rest":"https://alion.io/mcp/rest/get_company?id=3132"},"human":"https://alion.io/catalog?offer=company.slices&for=job%2Fveradigm-systems-analyst-payer-encounter-management-platform"},{"id":"market.stats","title":"A market slice: pay, demand and time to fill","status":"live","price":{"credits":1,"usd":0.1},"unit":"per slice","note":"pay, demand and time to fill for this role and place","call":{"mcp_tool":"market_stats"},"human":"https://alion.io/catalog?offer=market.stats&for=job%2Fveradigm-systems-analyst-payer-encounter-management-platform"},{"id":"job.search","title":"Open jobs by role, technology, place, pay and visa","status":"live","price":{"credits":0.02,"usd":0.002},"unit":"per posting in a list","note":"similar open postings","call":{"mcp_tool":"search_jobs"},"human":"https://alion.io/catalog?offer=job.search&for=job%2Fveradigm-systems-analyst-payer-encounter-management-platform"},{"id":"company.verify","title":"Is this company real and active right now","status":"pilot","price":null,"unit":"per company","request":{"url":"https://alion.io/catalog/request","method":"POST","body":"{\"offer\": \"company.verify\", \"for\": \"job/veradigm-systems-analyst-payer-encounter-management-platform\", \"note\": \"what you need it for\"}"},"human":"https://alion.io/catalog?offer=company.verify&for=job%2Fveradigm-systems-analyst-payer-encounter-management-platform"}]}