[Hiring] Lead Data Mining Content Ideation @Gainwell Technologies LLC

Role Description

As an Advisor, Data Mining Content Ideation, you will provide strategic and technical leadership in designing, implementing, and scaling advanced data mining and AI-enabled analytics solutions that identify improper payments and improve claims accuracy across medical, dental, and pharmacy domains.

• Act as Product Owner, Delivery Lead, and Implementation Manager for complex data mining and analytics initiatives.
• Design, develop, and implement advanced data mining and AI-driven analytics concepts to identify overpayments and improper payments.
• Support and lead responses to client RFPs, contributing superior written content related to data mining, AI, and payment integrity capabilities.
• Translate complex healthcare regulations, reimbursement methodologies, and clinical policies into scalable audit algorithms and analytic rules.
• Lead the incorporation of AI, machine learning, and advanced analytics techniques into payment integrity solutions.

Qualifications

• 7+ years of Healthcare Payment Integrity, Data Mining, or Advanced Analytics experience.
• Demonstrated experience in healthcare payment integrity data mining, including validation of claims data accuracy and payment accuracy.
• Proven experience applying CMS regulations, State/Federal guidelines, coding standards, and reimbursement policies to claims analytics.
• Strong experience translating business and policy requirements into technical and analytical solutions.
• Hands-on experience with AI/ML-driven analytics, such as predictive modeling, anomaly detection, pattern recognition, or NLP applied to healthcare or financial data.

Requirements

• Fully Remote Opportunity – Work from anywhere in the U.S.
• Minimal Travel Required – Occasional travel opportunities (0-10%).
• Video cameras must be used during all interviews, as well as during the initial week of orientation.
• The deadline to submit applications for this posting is November 1, 2026.
• The pay range for this position is $92,700.00 - $132,400.00 per year, depending on geographic region, internal equity, job-related knowledge, skills, and experience.

Benefits

• Generous, flexible vacation policy.
• 401(k) employer match.
• Comprehensive health benefits.
• Educational assistance.
• Leadership and technical development academies to help build your skills and capabilities.