Data Mining Manager — Savings & Recovery

Oscar Health; New York (NY); Hybrid; USD 112,000 - 147,000; Full time

Benefits offered by this job

Unlimited vacation

Annual performance bonuses

Health, dental and vision insurance

401(k) plan

Paid holidays

Wellness time

Job summary

Oscar Health in New York City is seeking a Manager, Data Mining to lead a specialized team within the Payment Integrity group. You will oversee data mining auditors, manage vendor relationships, and drive savings and recovery initiatives in post-payment processes.

Reporting to the Associate Director, Payment Integrity, you will design workflows, mentor staff, and collaborate with technology and data science to set effective detection algorithms while ensuring compliance with applicable laws.

Qualifications

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

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

Leadership

Healthcare operations

Team development

Workflow design

SQL basics

Education

Bachelor’s degree

Job description

Oscar Health in New York City is seeking a Manager, Data Mining to lead a specialized team within the Payment Integrity group. You will oversee data mining auditors, manage vendor relationships, and drive savings and recovery initiatives in post-payment processes.

Reporting to the Associate Director, Payment Integrity, you will design workflows, mentor staff, and collaborate with technology and data science to set effective detection algorithms while ensuring compliance with applicable laws.