数据挖掘经理 - 支付完整性
Manager, Data Mining - Payment Integrity
Hi, 我们是Oscar。我们正在招聘一名数据挖掘经理，加入我们的支付合规团队。
Oscar 是首家围绕完整技术平台和对服务会员的不懈专注而建立的健康保险公司。我们于2012年创立Oscar，旨在打造我们自己希望拥有的健康保险公司——一家像家庭医生一样的公司。
关于职位：
数据挖掘经理将领导一支个人贡献者团队，确保团队在支付合规领域达成节省和追回目标。您将领导支付后支付合规领域的数据挖掘审计人员，并监督数据挖掘供应商管理。
您将向支付合规副主管汇报工作。
工作地点：这是一个远程职位，面向以下地区的候选人：佐治亚州亚特兰大；伊利诺伊州芝加哥；德克萨斯州达拉斯；肯塔基州路易斯维尔；明尼苏达州明尼阿波利斯；宾夕法尼亚州费城；犹他州盐湖城。您将完全远程工作；不过，我们的工作方式可能会随时间调整。未来模式可能涉及在您所在都会区的中心办公室进行混合办公。#LI-Remote
薪资透明：此职位的基本薪资为：每年100,602-132,040美元。您还符合员工福利条件，可参与Oscar的无限休假计划和年度绩效奖金。
职责：
- 监督数据挖掘供应商提交的质量控制流程，确保准确性和符合项目标准
- 领导数据挖掘团队的日常运营，包括向内部审计人员和外部合作伙伴战略性地分配工作
- 制定团队的工作流程和指导方针，以实现一致且可衡量的结果
- 培训、教学和指导团队成员，使其更加熟练和高效
- 与Oscar的技术和/或数据科学团队合作，建立用于节省和追回识别的算法
- 遵守所有适用的法律法规
- 其他指定职责
要求：
- 本科学位或4年以上相关经验
- 4年以上医疗保健运营经验
- 2年以上领导和发展团队的经验
- 2年以上设计、实施和改进业务流程的经验
加分项：
- 在健康计划或供应商组织中拥有2年以上支付合规经验
- 具有医疗索赔处理经验
- 熟悉SQL及基本SQL能力
查看英文原文
Hi, we're Oscar. We're hiring a Manager, Data Mining to join our Payment Integrity team.
Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family.
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 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. #LI-Remote
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.
At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.
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.
Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant’s disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.
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