Pay: $100,602–132,040/year · Base — pay source
Work Location: This is a remote position, open to candidates who reside in: Atlanta, Georgia; Chicago, Illinois; Dallas, Texas; Louisville, Kentucky; Minneapolis, Minnesota; Philadelphia, Pennsylvania; Salt Lake City, Utah. You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area. #LI-Remote Pay Transparency: The base pay for this role is: $100,602- $132,040 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities:
Read the full posting
Work setup: Remote stated — work setup source
You will report into the Associate Director, Payment Integrity. Work Location: This is a remote position, open to candidates who reside in: Atlanta, Georgia; Chicago, Illinois; Dallas, Texas; Louisville, Kentucky; Minneapolis, Minnesota; Philadelphia, Pennsylvania; Salt Lake City, Utah. You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area. #LI-Remote Pay Transparency: The base pay for this role is: $100,602- $132,040 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.
Listed location: Remote
Read the full posting
Employment: Unconfirmed

What you’ll work on

The Manager of Data Mining leads a team of individual contributors, ensuring the team is meeting savings and recovery targets in the payment integrity space.

You will report into the Associate Director, Payment Integrity.

You will lead data mining auditors in the post-payment payment integrity space, and oversee data mining vendor management.
Oversee the quality control process for data mining vendor submissions, ensuring accuracy and alignment with program standards
Lead the daily operations of the data mining team, including the strategic delegation of work to both internal auditors and external partners

From the employer’s posting

The Manager of Data Mining leads a team of individual contributors, ensuring the team is meeting savings and recovery targets in the payment integrity space. You will lead data mining auditors in the post-payment payment integrity space, and oversee data mining vendor management.

You will report into the Associate Director, Payment Integrity.

About the role: The Manager of Data Mining leads a team of individual contributors, ensuring the team is meeting savings and recovery targets in the payment integrity space. You will lead data mining auditors in the post-payment payment integrity space, and oversee data mining vendor management. You will report into the Associate Director, Payment Integrity.

Responsibilities: Oversee the quality control process for data mining vendor submissions, ensuring accuracy and alignment with program standards Lead the daily operations of the data mining team, including the strategic delegation of work to both internal auditors and external partners

Oversee the quality control process for data mining vendor submissions, ensuring accuracy and alignment with program standards Lead the daily operations of the data mining team, including the strategic delegation of work to both internal auditors and external partners Develop team workflows and guidelines that produce consistent and measurable outcomes.

What you’ll bring

All qualifications

Core experience

4+ years experience in healthcare operations
2+ years of payment integrity experience at a health plan or vendor organization
2+ years of experience leading and developing a team
Experience with healthcare claims adjudication
2+ years experience designing, implementing and improving business workflows
Experience with SQL and basic SQL abilities

Qualification wording

4+ years experience in healthcare operations

2+ years of payment integrity experience at a health plan or vendor organization

2+ years of experience leading and developing a team

Experience with healthcare claims adjudication

2+ years experience designing, implementing and improving business workflows

Experience with SQL and basic SQL abilities

Education & alternatives

Requirements: - A bachelor’s degree or 4+ years of commensurate experience - 4+ years experience in healthcare operations

Tools in this posting

Source

- Experience with healthcare claims adjudication - Experience with SQL and basic SQL abilities - Medical coding certification through AAPC (CPC, COC) or AHIMA (CCS, RHIT, RHIA)

Job description

View original posting ↗

Hi, we're Oscar. We're hiring a Manager, Data Mining to join our Payment Integrity team.

Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family.

About the role:

The Manager of Data Mining leads a team of individual contributors, ensuring the team is meeting savings and recovery targets in the payment integrity space. You will lead data mining auditors in the post-payment payment integrity space, and oversee data mining vendor management.

You will report into the Associate Director, Payment Integrity.

Work Location: This is a remote position, open to candidates who reside in: Atlanta, Georgia; Chicago, Illinois; Dallas, Texas; Louisville, Kentucky; Minneapolis, Minnesota; Philadelphia, Pennsylvania; Salt Lake City, Utah. You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area. #LI-Remote

Pay Transparency: The base pay for this role is: $100,602- $132,040 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.

Responsibilities:

Oversee the quality control process for data mining vendor submissions, ensuring accuracy and alignment with program standards
Lead the daily operations of the data mining team, including the strategic delegation of work to both internal auditors and external partners
Develop team workflows and guidelines that produce consistent and measurable outcomes.
Train, teach and mentor team members to become more proficient and effective.
Partner with Oscar's technology and/or data science teams to establish algorithms for savings and recovery identifications.
Compliance with all applicable laws and regulations
Other duties as assigned

Requirements:

A bachelor’s degree or 4+ years of commensurate experience
4+ years experience in healthcare operations
2+ years of experience leading and developing a team
2+ years experience designing, implementing and improving business workflows

Bonus points:

2+ years of payment integrity experience at a health plan or vendor organization
Experience with healthcare claims adjudication
Experience with SQL and basic SQL abilities
Medical coding certification through AAPC (CPC, COC) or AHIMA (CCS, RHIT, RHIA)

This is an authentic Oscar Health job opportunity.

At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.

Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.

Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant’s disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.

California Residents: For information about our collection, use, and disclosure of applicants’ personal information as well as applicants’ rights over their personal information, please see our Privacy Policy.

Your next step

Have your CV and examples of relevant work ready.
Check the listed location, eligibility and core experience before starting.

Complete your application on job-boards.greenhouse.io. The employer’s form will show what is required.

Already applied? Track this application

Source & posting history

View original posting ↗

Source notes

Source excerpts

Selected passages from the saved posting. Check the full description for conditions and exceptions.

Pay: Work Location: This is a remote position, open to candidates who reside in: Atlanta, Georgia; Chicago, Illinois; Dallas, Texas; Louisville, Kentucky; Minneapolis, Minnesota; Philadelphia, Pennsylvania; Salt Lake City, Utah. You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area. #LI-Remote Pay Transparency: The base pay for this role is: $100,602- $132,040 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities:
Location & working pattern: Remote
You will report into the Associate Director, Payment Integrity. Work Location: This is a remote position, open to candidates who reside in: Atlanta, Georgia; Chicago, Illinois; Dallas, Texas; Louisville, Kentucky; Minneapolis, Minnesota; Philadelphia, Pennsylvania; Salt Lake City, Utah. You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area. #LI-Remote Pay Transparency: The base pay for this role is: $100,602- $132,040 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.
Work authorization: No clear work-authorization passage found. Eligibility is unconfirmed.

Open source at job-boards.greenhouse.io ↗Read the full description ↓