Sr Manager– Data Mining & Exploratory Intelligence

About the role

The ideal candidate brings extensive hands-on claims experience and can “reverse engineer” claims behavior to inform data-driven strategies, tools, and controls. Extensive experience across Medicare, Medicaid or commercial business Demonstrated expertise in 360-degree claims review, auditing, and payment integrity

What you'll do

• Lead exploratory analysis of claims paid data to identify utilization patterns, anomalies, and potential overpaid or inappropriate claims
• Perform reverse engineering of claims outcomes to understand root causes of payment issues and system behaviors
• Translate operational and claims insights into clear use cases, concepts, and solution ideas for analytics and product teams
• Partner closely with analytics, product, and strategy teams to ensure solutions align with real-world claims operations
• Support ongoing refinement and scaling of claims monitoring and overpayment detection capabilities

What you need

• 10–18 years in finance, audit & banking
• Claims processing
• Audit
• Product strategy
• Compliance
• Any graduate

What you get