S2Tech

Compensation

Full Description

MCO Encounter Systems Analyst [Pharmacy / NCPDP] Location: Remote – Eastern or Central Time Zone (preferred) About Us: Known for “Delighting the Client” through performance, innovation, and an employee-centric culture, S2Tech is a fast-growing IT consulting company serving clients in over a quarter of the United States. We are widely recognized as a leading provider of both technical and business services in support of Health and Human Services-related projects. Feel free to learn more at www.s2tech.com. Why S2Tech?: • Stable privately-owned company with a strong reputation for building long-term client relationships through the delivery of consistent value-based service • 25+ years providing IT and Business services to private customers and government programs throughout the United States • Expansive client portfolio and active projects – employees benefit from innovative project exposure and in-house skill development training/courses • Corporate culture that emphasizes the importance of family and promotes a healthy work-life balance • Offer competitive pay and a range of benefits, including: • Medical / Dental / Vision Insurance – insurance premium assistance provided • Additional Insurance (Life, Disability, etc.) • Paid Time Off • 401(k) Retirement Savings Plan & Health Savings Account • Various training courses to promote continuous learning • Corporate Wellness Program • Be part of a company that gives back through its non-profit organization, Fortune Fund, which was launched in 2001. The goal of the Fortune Fund is to close the rural/urban divide by ensuring children in rural communities in India and the United States understand the importance of education & are aware of professional career opportunities, allowing them to link their professional & educational goals Job Overview: S2Tech is seeking an experienced MCO Encounter Systems Analyst with a strong background in Medicaid or Managed Medicaid encounter processing, pharmacy transactions, and NCPDP standards. This role sits at the intersection of business operations and technical analysis, supporting a Managed Care Organization (MCO) encounter team. The ideal candidate will have hands-on experience analyzing, troubleshooting, and improving encounter file submissions from health plans - with strong competency in pharmacy claims, SQL, and data formats. This position requires excellent communication, structured organization, and the ability to manage multiple activities in parallel while collaborating with both internal technical teams and external MCO partners. Responsibilities: • Serve as a primary point of contact for MCOs regarding encounter file submissions, processing results, and issue resolution • Troubleshoot rejected or failed encounters by reviewing edits, analyzing root causes, and guiding MCOs toward corrective actions • Review, interpret, and validate NCPDP-standard pharmacy encounter transactions across various versions • Apply strong SQL skills to query, analyze, and validate encounter and pharmacy claims data • Collaborate with internal technical teams (EDI, data, systems) to investigate issues and explain findings to stakeholders • Maintain detailed logs and status trackers for ongoing MCO interactions, encounter cycles, open issues, and pending follow-ups • Provide clear, concise updates to internal peers and organizational stakeholders on encounter processing activities • Support continuous process improvements related to encounter intake, validation, analysis, and provider plan communication • Ensure compliance with encounter submission standards, data formats, and Medicaid/Managed Medicaid requirements Qualifications: • 5+ years of experience working with Medicaid, Managed Medicaid, or PBM encounter data (competency prioritized over tenure) • Strong knowledge of NCPDP standard transactions and pharmacy claims processing requirements • Strong technical skills, including: • SQL (queries, analysis, troubleshooting) • Understanding of data formats and encounter file structures • Experience working in or alongside MCOs, PBMs, health plans, or Medicaid programs • Proven ability to communicate effectively with both technical and non-technical stakeholders • Strong organizational skills with the ability to manage multiple concurrent activities • Experience in documenting issue resolutions, maintaining logs, and preparing status updates Preferred: • Experience in a Systems Analyst or Business Systems Analyst role • Background in pharmacy benefit management, pharmacy encounters, or post-adjudication data • Familiarity with EDI environments, encounter rejection codes, or companion guide requirements • Experience supporting cross-functional teams in a remote environment S2Tech is committed to hiring and retaining a diverse workforce. We are an equal opportunity employer making decisions without regard to age, race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected class.