Senior Director, Data Mining Ideation

Rawlings Company; La Grange (KY); On-site; USD 180,000 - 280,000; Full time

Job summary

Machinify, a leading healthcare intelligence company, seeks a Sr Director of Data Mining Ideation to lead a team delivering accurate findings on improper payments. This delivery-focused leadership role balances quality, timeliness, and cost within a vendor model and partnerships with client-aligned stakeholders.

You will own day-to-day delivery, team development, budgets, and operational targets while driving automation and AI-assisted tooling to improve throughput and accuracy.

Qualifications

• 8+ years in healthcare payment integrity, claims analytics, audit operations, or a similar delivery function.
• 2+ years leading teams.
• Demonstrated success managing budgets, headcount planning, and operational forecasting.
• Track record of scaling and maturing an execution-oriented team with metrics.
• Strong communication and executive presence with ability to build trust across teams.
• Comfort partnering with technical teams and interpreting analytical outputs.

Responsibilities

• Lead and develop the team; provide leadership, mentorship, and performance management.
• Oversee workflow planning, prioritization, and quality assurance for findings and outputs.
• Own annual and ongoing budgets including capacity forecasting and headcount planning.
• Improve processes with automation and AI-assisted tooling to raise throughput and accuracy.
• Proactively report performance, risks, and delivery status to senior leadership and stakeholders.
• Communicate product improvements or client needs to leadership and clients.

Skills

Leadership

Budgeting

Forecasting

Executive presence

Communication

Tools

AI tools

Job description

Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plan clients across the country. Deployed by over 85 health plans, including many of the top 20, and representing more than 270 million lives, Machinify brings together a fully configurable and content-rich, AI-powered platform along with best-in-class expertise. We're constantly reimagining what's possible in our industry, creating disruptively simple, powerfully clear ways to maximize financial outcomes and drive down healthcare costs.

We are seeking a Sr Director of Data Mining Ideation to lead and scale the team that turns data mining and audit-support work into accurate, actionable findings on improper payments. As the Sr. Director, you will own day-to-day delivery, the team's development, and the operational targets, and you will do it inside a vendor delivery model, working closely with client-aligned stakeholders and internal partners. This is a delivery-focused leadership role for someone who balances quality, timeliness, and cost, and who builds strong teams that do the same.

What you'll do

Lead and develop the team

• Provide direct leadership, mentorship, and performance management for operational data mining professionals.
• Set clear expectations, build a strong team culture, and establish coaching and training routines that keep the team sharp on both technical skills and operational discipline.

Deliver high-quality work on time

• Oversee workflow planning, prioritization, and quality assurance for audit-support findings, data-driven insights, and reporting outputs.
• Make sure outputs are accurate, consistent, and actionable, and that the team meets agreed service levels and operational commitments.
• Drive measurable value for clients by supporting the identification of improper payments across.

Own the operational budget

• Manage, and deliver against annual and ongoing budgets, including capacity forecasting, headcount planning, and monitoring of operational spend.
• Make and recommend tradeoffs on staffing, throughput expectations, tooling, and workflow optimization, and report budget performance clearly to leadership.
• Balance cost efficiency with scalable, high-quality delivery.

Improve how the work gets done

• Run the team with strong metrics discipline, clear accountability, and consistent operating rhythms.
• Continuously improve operational processes, including where automation and AI-assisted tooling can raise throughput and accuracy.
• Partner with analytics, data engineering, reporting, product, and client-facing operations to resolve dependencies and surface needs and risks early.

Communicate with executive presence

• Proactively report performance, risks, and delivery status to senior leadership and client-aligned stakeholders.
• Translate operational realities into clear, concise summaries for upper management, and contribute to operational planning discussions.
• Ability to meet with clients to understand needed product enhancements or other client needs.

What experience you bring (Role Requirements)

• 8+ years of experience in healthcare payment integrity, claims analytics, audit operations, or a similar delivery function, including 2+ years leading teams.
• Demonstrated success managing budgets, headcount planning, and operational forecasting in a fast-paced, service-oriented environment.
• Track record of scaling and maturing an execution-oriented team and managing performance through metrics and quality standards.
• Strong communication and executive presence, with the ability to build trust across teams, manage competing priorities, and deliver results through others.
• Comfort partnering with technical teams and interpreting analytical outputs.

Strongly preferred

• Familiarity with healthcare claims data, audit processes, payment integrity concepts, and data mining approaches.
• Experience in vendor-client delivery models.
• Experience with AI tools.

Equal Employment Opportunity at Machinify

We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace. Machinify is an employment at will employer. We participate in E-Verify as required by applicable law. In accordance with applicable state laws, we do not inquire about salary history during the recruitment process. If you require a reasonable accommodation to complete any part of the application or recruitment process, please let our recruiters know. See our Candidate Privacy Notice at: https://www.machinify.com/candidate-privacy-notice/