Remote Data Mining Manager: Payment Integrity Lead

Oscar-Health-; Atlanta (GA); Remote; USD 101,000 - 132,000; Full time

Benefits offered by this job

Unlimited vacation

Annual performance bonuses

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

Job summary

Oscar Health seeks a Manager of Data Mining to lead a team focused on savings and recovery in payment integrity. This remote role reports to the Associate Director, Payment Integrity and requires experience in healthcare operations and data analytics.

You will supervise vendors, collaborate with technology teams, and ensure compliant, high-quality data mining outputs while guiding the team to meet targets and improve workflows.

Qualifications

• Bachelor’s degree or 4+ years of commensurate experience.
• 4+ years experience in healthcare operations.
• 2+ years leading and developing a team.
• 2+ years designing, implementing and improving business workflows.
• 2+ years of payment integrity experience at a health plan or vendor.
• Experience with healthcare claims adjudication.
• Experience with SQL and basic SQL abilities.
• Medical coding certification through AAPC (CPC, COC) or AHIMA (CCS, RHIT, RHIA).

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

Healthcare operations

Team leadership

Data mining

Education

Bachelor’s degree or 4+ years of commensurate experience

Tools

SQL

Job description

Oscar Health seeks a Manager of Data Mining to lead a team focused on savings and recovery in payment integrity. This remote role reports to the Associate Director, Payment Integrity and requires experience in healthcare operations and data analytics.

You will supervise vendors, collaborate with technology teams, and ensure compliant, high-quality data mining outputs while guiding the team to meet targets and improve workflows.