Aledade is a national leader empowering primary care organizations with actionable insights to improve patient health and support business sustainability. Backed by Lightspeed.
About the role
The Manager, Clinical Data Management is responsible for the full lifecycle of our Encounter Data Submission and Reconciliation strategy, ensuring that diagnoses are accurately tracked, submitted, and accepted by payers and CMS. In this role, you’ll lead the operational and strategic work that turns clinical documentation into reliable, compliant, and financially meaningful data. Found on 1752vc Careers, the job board for startup and VC roles.
What they're looking for
- Bachelor’s degree in Business, Finance, IT, Healthcare Analytics, or Operations
- 6+ years of experience with Medicare Advantage or ACA encounter data processes, and/or risk adjustment experience within a payer, vendor, or Value Based Care organization
- 3+ years of program or project management experience, including ownership of complex, multi-stakeholder initiatives
- 2+ years of working knowledge with X12 837 transaction sets, Working knowledge of CMS EDPS experience (MAO-002/MAO-004 reports)
- Strong analytical capabilities with a demonstrated ability to interpret complex datasets and synthesize actionable insights
- Excellent written and verbal communication skills, with proven experience developing and presenting key information to executive leadership
More about this role
The Manager, Clinical Data Management is responsible for the full lifecycle of our Encounter Data Submission and Reconciliation strategy, ensuring that diagnoses are accurately tracked, submitted, and accepted by payers and CMS. In this role, you’ll lead the operational and strategic work that turns clinical documentation into reliable, compliant, and financially meaningful data. You’ll collaborate across internal teams, vendors, and payers to spot gaps early, solve root causes, and continuously improve how we submit and reconcile encounter data. If you thrive at the intersection of healthcare data, process ownership, and cross-functional leadership, this role offers the chance to make a measurable difference.
- Oversee end-to-end strategy, priorities, and operations for accurate and compliant encounter data submission to payers and CMS.
- Create and transmit ASM files on established cadences, maintaining payer-specific templates and submission methods annually.
- Establish routine reconciliation processes to track diagnoses from documentation to acceptance, quantifying gaps and identifying dropped/truncated records early.
- Lead root-cause analysis and corrective action across...
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