[Hiring] Manager, Data Mining @Oscar Health

Role Description

Hi, we're Oscar. We're hiring a Manager, Data Mining to join our Payment Integrity team. The Manager of Data Mining leads a team of individual contributors, ensuring the team is meeting savings and recovery targets in the payment integrity space. You will lead data mining auditors in the post-payment payment integrity space, and oversee data mining vendor management. You will report into the Associate Director, Payment Integrity.

Work Location:

• This is a remote position, open to candidates who reside in:
• Atlanta, Georgia
• Chicago, Illinois
• Dallas, Texas
• Louisville, Kentucky
• Minneapolis, Minnesota
• Philadelphia, Pennsylvania
• Salt Lake City, Utah
• You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area.

Pay Transparency:

• The base pay for this role is: $100,602- $132,040 per year.
• You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, and annual performance bonuses.

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.

Qualifications

• A 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.

Requirements

• 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 (CPC, COC) or AHIMA (CCS, RHIT, RHIA).

Benefits

• Full-time employees are eligible for benefits including:
• 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.