Encounter Data Quality Control Analyst (ITBA-SS/AHSO)

State of Washington
State of Washington

IT, Data Science, Quality Assurance

Thurston County, WA, USA

Posted on Jun 12, 2026

Description

Encounter Data Quality Control Analyst (ITBA-SS/AHSO)

71036005

This position is responsible for the quality and validity of encounter data and working with Managed Care Organizations (MCO) and Behavioral Health Administrative Service Organizations (BH-ASO) to ensure accurate and complete data that is used for risk corridors, gain sharing, rate setting and service-based enhancements. This position will also resolve any complex system or payment issues. This analyst uses communication skills as the face of the agency data quality meetings with external health care organizations as well as SQL skills in performing data quality work. If you are a strong facilitator with BABOK experience and an interest in supporting important public health data work in Washington, this may be the opportunity for you!

All HCA employees will apply an equity lens to their work, which may include but is not limited to all analyses of core business and processes.

About the division:

ProviderOne is the Health Care Authority’s (HCA) mission critical Medicaid Management Information System (MMIS). This large-scale enterprise system is operated and managed within the Apple Health Services and Operations (AHSO) Division, ProviderOne Operations (P1O) section and processes over five million claims/encounters per month and processes payments in excess of $14 billion annually to providers for services to Medicaid clients statewide.

About the position:

This senior-level Encounter Data Quality Control Analyst position resides within the Managed Care Operations and Implementation Unit (MCOIU) and reports to the Policy & Planning – Senior/Specialist, MCOIU Manager. This position is responsible for providing a detailed level of information technology services for the ProviderOne MMIS.

This position is eligible to telework and is typically not required to report on-site. The default assigned work location of all Health Care Authority (HCA) positions – both on-site and telework eligible positions – is within the State of Washington. This position reports to Olympia, WA. Frequency of onsite work will vary based on business and operational needs. All agency employees are required to report on-site in Olympia on their first and last days of employment to pick up and return state-issued equipment, regardless of telework status or location.

Duties

Some of what you will do:

  • Provide subject matter expertise and skilled consultative service for ProviderOne system changes and enhancements.
  • Oversee ProviderOne encounter data operations and prioritize, analyze, and address issues
  • Within stringent timelines, monitor encounter data submissions and re-submissions from HCA contracted Managed Care Organizations (MCO) and Behavioral Health Administrative Service Organizations (BH-ASO), evaluating encounter data for timeliness, quality, completeness, and validity.
  • Engage in discussions at the executive level (with HCA and MCO/BH-ASOs) on possible resolutions to new unfolding business changes.
  • Provide direction and oversight to workgroups and staff in order to develop strategy for implementing new solutions and programs.
  • Manage and resolve complex subsystem issues that are escalated by staff or the MCO/BH-ASOs. Directs staff on approaches for resolving these issues.
  • Liaise and negotiate between the business, stakeholders, and vendor (system integrator) to ensure consistency, understanding, and efficiency in processes and logic.
  • Communicate encounter data claims submission requirements with the MCO/BH-ASOs. Provide education and training for these organizations regarding encounter data exchange standards.
  • Responsible for maintaining the ProviderOne Encounter Data Reporting Guide including drafting new language as well as managing updates.
  • Function as the technical specialist on system functionality, features, system issues, and unresolved system problems
  • Provide guidance to junior P1O staff on complex issues.
  • Perform IT Business Analysis Body of Knowledge (BABOK) disciplines and related methodologies.

Qualifications

Required qualifications:

Qualifying candidates will satisfy one of the following criteria options:

Option 1:

  • Nine (9) years of progressive professional IT experience in one or more of the following areas:
    • consulting, analyzing, designing, programming, installing, and/or maintaining computer software applications, hardware, telecommunications, or network infrastructure equipment;
    • directing IT projects;
    • providing IT customer or technical support; or
    • administering or supervising staff who performed work in any of these IT disciplines.

Option 2:

  • Associate degree in information technology, computer science, or IT related field or equivalent and
  • Seven (7) years of progressive professional IT experience in one or more of the areas identified in Option 1.

Option 3:

  • Bachelor’s degree in information technology, computer science, or IT related field or equivalent and
  • Five (5) years of progressive professional IT experience in one or more of the areas identified in Option 1.

Option 4:

  • Master’s degree in information technology, computer science, or IT related field or equivalent and
  • Three (3) years of progressive professional IT experience in one or more of the areas identified in Option 1.

Option 5:

  • Three (3) years as a journey level IT professional in state government performing one or more of the experiences listed in Option 1.

Qualifying candidates will also satisfy all of the following criteria (experience may be gained concurrently):

  • Four (4) years of experience with vendor / System Integrator management and facilitating systems development sessions and relationships.
  • Two (2) years of knowledge and hands-on experience with Software Development Life Cycle (SDLC).
  • Two (2) years of demonstrated experience with best practice Business Analysis methodologies based on the International Institute of Business Analysis, Business Analysis Body of Knowledge (BABOK Guide and Standards).

Required competencies:

  • The ability to take action to learn and grow.
  • The ability to take action to meet the needs of others.

Preferred qualifications:

  • Demonstrated professional experience:
  • Using SQL to write and pull data queries.
  • Analyzing large, complex data sets being used to make highly visible enterprise-wide decisions.
  • Effectively communicating orally and in writing with large groups (100+) of internal and external stakeholders regarding detailed and/or technical content, such as contract language and deliverables.
  • Facilitating meetings with external stakeholders.
  • Building reports and creating data extracts from a data warehouse.
  • Highly skilled level analytical, facilitation, systems and organizational skills.

How to apply:

Only candidates who reflect the minimum qualifications on their NEOGOV profile will be considered. Failure to follow the application instructions below may lead to disqualification. To apply for this position, you will need to complete your profile which includes three professional references and attach in separate files:

  • A cover letter that specifically addresses how you meet the qualifications for this position
  • Current resume

To take advantage of veteran preference, please do the following:

  • Attach a copy of your DD214 (Member 4 long-form copy), NGB 22, or USDVA signed verification of service letter.
  • Please black out any PII (personally identifiable information) data such as social security numbers. Include your name as it appears on your application in careers.wa.gov.

Supplemental Information

About HCA:

Functioning as both the state's largest health care purchaser and its behavioral health authority, the Washington State Health Care Authority (HCA) is a leader in ensuring Washington residents have the opportunity to be as healthy as possible.

There are three pillars of our work: Apple Health (Medicaid); the Public Employees Benefits Board (PEBB) and School Employees Benefits Board (SEBB) programs; and behavioral health and recovery. Under these pillars, HCA purchases health care, including behavioral health treatment for more than 2.7 million Washington residents and provides behavioral health prevention, crisis, and recovery supports to all Washington residents.

What we have to offer:

  • Meaningful work with friendly co-workers who care about those we serve Voices of HCA
  • A clear agency mission that drives our work and is person-centered HCA's Mission, Vision & Values
  • A healthy work/life balance, including alternative/flexible schedules and mobile work options.
  • A great total compensation and benefit package WA State Government Benefits
  • A safe, pleasant workplace in a convenient location with restaurants, and shopping nearby.
  • And free parking!

Notes:

This position is covered by the Washington Federation of State Employees (WFSE). Once the listed position(s) is(are) filled, this recruitment announcement may also be used to fill additional position(s) for up to sixty (60) days.

Prior to a new hire, a background check including criminal record history will be conducted. Information from the background check will not necessarily preclude employment.

HCA is an equal opportunity employer. We value the importance of creating an environment in which all employees can feel respected, included, and empowered to bring unique ideas to the agency. HCA has five employee resource groups (ERGs). ERGs are voluntary, employee-led groups whose aim is to foster a diverse, inclusive workplace aligned with HCA’s mission. Our diversity and inclusion efforts include embracing different cultures, backgrounds and viewpoints while fostering growth and advancement in the workplace. Studies have shown women, racial and ethnic minorities, and persons of disability are less likely to apply for jobs unless they feel they meet every qualification as described in a job description. Persons over 40 years of age, disabled and Vietnam era veterans, as well as people of all sexual orientations and gender identities are also encouraged to apply. If you have any questions about the required qualifications or how your experience relates to them, please contact us at HCAjobs@hca.wa.gov. Persons with disabilities needing assistance in the application process, or those needing this job announcement in an alternative format may contact Jake Nelko at 360-725-0945 or jake.nelko@hca.wa.gov.

The Washington State Health Care Authority (HCA) is an E-Verify employer. All applicants with a legal right to work in the United States are encouraged to apply.

E-Verify® is a registered trademark of the U.S. Department of Homeland Security.

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