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About the Role
The Manager of Data Mining leads a team of individual contributors, ensuring the team meets 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, reporting 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.
- 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.
- 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).
Location
- New York City
Work Type
- Hybrid
Experience Level
- Manager
Education Level
- Bachelor's degree
Salary/Compensations
- $111,780 - $146,711 per year
Benefits
- Medical, dental, and vision benefits
- 11 paid holidays
- Paid sick time
- Paid parental leave
- 401(k) plan participation
- Life and disability insurance
- Paid wellness time and reimbursements
- Unlimited vacation program
- Annual performance bonuses
About the Company
- 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.
Equal 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.
- Oscar applicants are considered solely based on their qualifications, without regard to applicant’s disability or need for accommodation.