Machinify

The future of payment integrity.

Manager, Data Mining – Review Operations

OperationsOperationsFull TimeRemoteTeam 1,001-5,000Company SiteLinkedIn

Location

New York

Posted

7 days 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

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