Data Mining Manager (Payment Integrity)

Oscar Health; Phoenix (AZ); Hybrid; USD 101,000 - 132,000; Full time

Benefits offered by this job

Health benefits

Unlimited vacation

Annual bonus eligibility

Job summary

Oscar Health in Tempe, Arizona, is seeking a Manager, Data Mining to lead a team focused on savings and recovery identifications within the payment integrity space. The role reports to the Associate Director, Payment Integrity, and requires hybrid work with three in-office days per week, including Thursdays for meetings and events.

The base pay ranges from $100,602 to $132,040 per year, with eligibility for benefits, unlimited vacation, and annual performance bonuses.

Qualifications

• 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 or AHIMA.

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.

Skills

SQL

Team leadership

Healthcare operations

Workflow design

Education

Bachelor's degree or 4+ years of commensurate experience

Job description

Oscar Health in Tempe, Arizona, is seeking a Manager, Data Mining to lead a team focused on savings and recovery identifications within the payment integrity space. The role reports to the Associate Director, Payment Integrity, and requires hybrid work with three in-office days per week, including Thursdays for meetings and events.

The base pay ranges from $100,602 to $132,040 per year, with eligibility for benefits, unlimited vacation, and annual performance bonuses.