Sr Manager– Data Mining & Exploratory Intelligence

Ex; Hyderabad; On-site; INR 600,000 - 1,000,000; Full time

Job summary

Ex is seeking a seasoned analytics professional to identify patterns, anomalies, and potential overpayments across Medicare, Medicaid, and commercial claims. You will translate operational insight into analytics concepts and solutions.

The role requires hands-on claims experience, the ability to reverse engineer claims behavior, and strong collaboration with analytics, product, strategy, and compliance teams to drive data-driven controls.

Qualifications

• Extensive experience across Medicare, Medicaid or commercial business.
• 360-degree claims review, auditing, and payment integrity.
• Identify patterns, anomalies, and inappropriate payments within large claims datasets.
• Bridge operations and data science with strong analytics.

Responsibilities

• Identify patterns, anomalies, and inappropriate payments within large claims datasets.
• Reverse engineer claims behavior to inform data-driven strategies, tools, and controls.
• Collaborate with analytics, product, strategy, and compliance teams.
• Explain complex claims concepts clearly to stakeholders.

Skills

Medicare/Medicaid experience

Claims analysis

Data mining

Pattern detection

Payment integrity

Reverse engineer claims behavior

Analytical mindset

Cross-functional collaboration

Communication skills

Job description

This role will focus on identifying claims patterns, anomalies, and potential overpayments across Medicare, Medicaid and commercial business, while translating deep operational insight into actionable analytics concepts and solutions.

The ideal candidate brings extensive hands-on claims experience and can “reverse engineer” claims behavior to inform data‑driven strategies, tools, and controls.

• Extensive experience across Medicare, Medicaid or commercial business
• Demonstrated expertise in 360-degree claims review, auditing, and payment integrity
• Proven ability to identify patterns, anomalies, and inappropriate payments within large claims datasets
• Strong analytical mindset with the ability to bridge operations and data science
• Experience collaborating with cross-functional teams (analytics, product, strategy, compliance)
• Excellent communication skills with the ability to explain complex claims concepts clearly
• Prior involvement in payment integrity Data Mining or recovery initiatives
• Experience supporting or designing claims analytics or data mining non-clinical programs