Oscar Health Insurance Co

Manager, Data Mining - Payment Integrity

Oscar Health Insurance Co$100K — $132K *
Tempe, AZ 85281In-Person
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's degree or 4+ years of relevant experience
  • 4+ years in healthcare operations
  • 2+ years of leadership and team development
  • 2+ years in designing and improving business workflows

Responsibilities

  • Oversee quality control for vendor data submissions
  • Lead daily operations and delegate work strategically
  • Develop workflows for consistent outcomes
  • Mentor and train team members for effectiveness
  • Collaborate with technology teams on algorithms for savings
  • Ensure compliance with all laws and regulations
  • Perform other assigned duties as needed

Benefits

  • 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
Full Job Description
Hi, we're Oscar. We're hiring a Manager, Data Mining to join our Payment Integrity team.

About the role:

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 position is based in our Tempe, Arizona office, requiring a hybrid work schedule with 3 days of in-office work per week. Thursdays are a required in-office day for team meetings and events, while your other two office days are flexible to suit your schedule. #LI-Hybrid

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

Requirements:
  • 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

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)


This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.

Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. 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, and paid wellness time and reimbursements.

Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.

About Oscar Health Insurance Co

Oscar Health Insurance Co. is a technology-driven health insurance company founded in 2012 and headquartered in New York City. The company offers individual and family health insurance plans, as well as Medicare Advantage plans. Oscar Health Insurance Co. uses technology to simplify the health insurance experience for its customers, including a mobile app that allows customers to manage their health insurance policies and access telemedicine services. The company has raised over $1 billion in funding and is valued at over $5 billion.
Learn more about Oscar Health Insurance Co
Size
4,000 employees
Market Cap
$466 million
Industry
Founded
2012
NASDAQ

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