Manager, Data Mining (Payment Integrity)

Location: New York City office with a hybrid schedule requiring 3 days of in-office work per week; Thursdays are required in-office days

Salary: $111,780–$146,711 per year, plus performance bonuses and employee benefits.

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 the data mining team and oversee daily operations in the post-payment payment integrity space.
• Manage the strategic delegation of work to internal auditors and external partners.
• Oversee quality control for data mining vendor submissions, ensuring accuracy and alignment with program standards.
• Develop workflows and guidelines that produce consistent, measurable 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.
• Ability to work in the New York City office 3 days per week, including Thursdays.

Nice to have

• 2+ years of payment integrity experience at a health plan or vendor organization.
• Experience with healthcare claims adjudication.
• SQL experience and basic SQL abilities.
• Medical coding certification through AAPC or AHIMA.

Culture & Benefits

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