$250K — $500K+*
The Data Mining Group (DMG) Director is responsible for leading the Payment Integrity Division in our mining efforts. The successful candidate will set the strategy and develop new initiatives for the Data Mining Group. You will be responsible for the leadership and development of the overall data mining team, while also managing several high impact projects. You will maintain regular communication with all levels of the organization. You will need to drive continuous improvement within the team and the mining processes.
The Rawlings Group provides payment integrity services and claims data analysis for health insurance carriers and their members. We work behind the scenes to make sure that members are receiving the full value of their coverage by ensuring that claims are appropriately paid. Providing payment integrity and recovery services to the industry creates a more equitable distribution of healthcare dollars so members can receive the care they need when they need it most. We offer opportunities for growth and development, continuing education, internal mobility and promotions, and unrivaled income earning potential. We are looking for individuals that have the drive and commitment to make a difference in the industry. We invite you to apply to become a part of The Rawlings Group team.
Our Culture is focused on:
The guiding principle of doing the right thing
Caring for our employees and taking pride in the work they do
Providing recognition and financially rewarding employees for their success
Our Values are:
Integrity and Trust
Customer Service Excellence
Diversity and Inclusion
Honoring our Veterans and their service
Collaborate with business to set the strategy and initiatives for the Data Mining Group and lead the team in the execution of those initiatives.
Develop a detailed understanding of business policies and objectives, and communicate regularly with Operations to create audits or analysis that align with changing business needs
Lead and develop team members to prepare for future growth opportunities and develop a positive team culture.
Communicate with Executive staff on DMG mining and initiative results.
Work with leadership to ensure that efforts are prioritized and resources are allocate appropriately
Ensure accurate and timely results from mining and enrichment processes
Alongside DMG managers, capture feedback from analysts about audit quality to improve future quality of mining results
Support implementation of new clients and changes to existing client processes, including post-implementation analysis of results
Alongside Business, define reporting needs and lead DMG in delivering those reports.
At least 2 years of experience in the insurance or healthcare industry.
3-5 years of Management/Leadership experience
Proactive, inquisitive and creative in approach to work
At least five years of professional experience with SQL Server.
At least two years of Python experience (or similar general-purpose language)
Experience building SSIS packages
Ability to present major initiatives and results to Leadership
Ability to build and maintain solid working relationships across the organization.
Strong analytical mindset and eagerness to learn a complex business
High attention to detail and data accuracy
Excellent problem solving, time-management, and task prioritization skills.
Ability to handle multiple projects effectively
Capability to work in a small team setting.
The ability to work at our Facility and maintain our regular work schedule of Monday through Friday, 8:00 am- 5:00 pm.
The ability to perform other duties as assigned.
Valid through: 11/2/2021