Manager, Data Mining - Payment Integrity

Location: Fully remote for candidates residing in Atlanta, Chicago, Dallas, Louisville, Minneapolis, Philadelphia, or Salt Lake City; the role may eventually involve hybrid presence at the associated hub office.

Salary: $100,602–$132,040 per year, plus annual performance bonuses.

Company

hirify.global is a health insurance company built around a full-stack technology platform and a focus on member experience.

What you will do

• Lead post-payment data mining auditors and manage the daily operations of the payment integrity team.
• Oversee quality control for data mining vendor submissions and ensure alignment with program standards.
• Delegate work across internal auditors and external partners.
• Develop workflows and guidelines that deliver consistent, measurable savings and recovery outcomes.
• Train, mentor, and develop team members.
• Partner with technology and data science teams to establish algorithms for identifying savings and recoveries.

Requirements

• Bachelor’s degree or 4+ years of equivalent experience.
• 4+ years of experience in healthcare operations.
• 2+ years of experience leading and developing a team.
• 2+ years of experience designing, implementing, and improving business workflows.
• Compliance with applicable laws and regulations.
• Residence in one of the listed U.S. metropolitan areas is required for the remote role.

Nice to have

• 2+ years of payment integrity experience at a health plan or vendor organization.
• Experience with healthcare claims adjudication.
• Basic SQL skills.
• Medical coding certification such as AAPC CPC or COC, or AHIMA CCS, RHIT, or RHIA.

Culture & Benefits

• Medical, dental, and vision benefits.
• Unlimited vacation program, paid holidays, paid sick time, and paid parental leave.
• 401(k) participation, life and disability insurance, and paid wellness time and reimbursements.
• Annual performance bonuses.
• Equal opportunity environment focused on belonging and support.