Machinify
The future of payment integrity.
Manager, Data Mining – Review Operations
Location
New York
Posted
7 hours ago
Salary
Not specified
English
Job Description
• Lead a team responsible for operational execution of data mining and claims review activities
• Oversee day-to-day review operations supporting Medicaid RAC initiatives
• Provide direct supervision, coaching, and performance management for a team
• Ensure that review selections align with approved RAC scopes
• Coordinate closely with analytics, data engineering, quality assurance, and reporting teams
• Support budget adherence and operational forecasting for their team
Job Requirements
- Strong communication and collaboration skills
- State Medicaid RAC experience is required
- Experience operating within a State Medicaid Recovery Audit Contractor program
- Familiarity with RAC audit scopes, claim review methodologies
- Ideal candidate needs familiarity with NYS Medicaid policies, OMIG expectations
- Proven ability to manage deadlines, enforce quality standards, and deliver results
Benefits
- Work from anywhere in the US!
- Top Medical/Dental/Vision offerings
- FSA/HSA
- Tuition reimbursement
- Competitive salary, 401(k) with company match
- Additional health and wellness benefits and perks
- Flexible and trusting environment where you’ll feel empowered to do your best work
