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Director of Data Mining Operations (Healthcare Payment Integrity)

Remote - US

Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plan clients across the country. Deployed by over 85 health plans, including many of the top 20, and representing more than 270 million lives, Machinify brings together a fully configurable and content-rich, AI-powered platform along with best-in-class expertise. We’re constantly reimagining what’s possible in our industry, creating disruptively simple, powerfully clear ways to maximize financial outcomes and drive down healthcare costs.

About the opportunity

We are seeking a results-driven Director of Data Mining Operations to lead and scale a high-performing team responsible for operational execution of data mining and audit-support activities in the healthcare payment integrity domain. This role is ideal for a proven people leader who thrives in a delivery-focused environment and can balance quality, timeliness, and team development while operating within clear financial expectations. The Director will be accountable for ensuring operational outputs are accurate, consistent, and actionable, supporting the identification of improper payments and driving measurable value for clients. This position is a leadership role within a vendor delivery model and requires the ability to manage internal execution while collaborating closely with client-aligned stakeholders and internal cross-functional partners.

What you'll do

The Director will provide direct leadership, mentorship, and performance management for a team of operational data mining professionals. This includes setting clear expectations, building strong team culture, establishing coaching and training routines, and ensuring the team is consistently well-groomed in both technical capability and operational discipline. The Director will be responsible for ensuring work is executed with high quality and within expected timelines, including oversight of workflow planning, prioritization, quality assurance, and delivery of audit-support findings, data-driven insights, and reporting outputs. This leader will continuously improve operational processes and performance through strong metrics discipline, clear accountability, and effective collaboration with adjacent teams such as analytics, data engineering, reporting, product, and client-facing operations.

A core responsibility of this role is ownership of the operational budget. The Director will be expected to build, manage, and deliver against annual and ongoing budgets, including forecasting capacity needs, managing headcount planning, monitoring operational spend, and ensuring the organization meets financial targets while maintaining delivery quality. This includes making tradeoffs and recommendations related to staffing, throughput expectations, tooling needs, and workflow optimization, and communicating budget performance clearly to leadership. The Director will be accountable for ensuring the team meets agreed service levels and operational commitments while maintaining cost efficiency and scalable delivery.

What experience you bring (Role Requirements)  

This role requires strong communication and executive presence. The Director will serve as a key operational leader who collaborates closely with peers and senior leadership, proactively communicates performance, risks, and delivery status, and ensures leadership has confidence in execution. The Director will be expected to translate operational realities into clear, actionable summaries for upper management, contribute to operational planning discussions, and represent the team’s performance, needs, and opportunities in a highly collaborative way. Success in this role requires a leader who can manage competing priorities, build trust across teams, and consistently deliver results through others.

The ideal candidate will have significant experience leading operational data mining, claims analytics, payment integrity, audit operations, or similar delivery functions in a healthcare environment. They will bring strong people leadership experience, the ability to scale and mature an execution-oriented team, and the discipline to manage performance through metrics, quality standards, and clear operating rhythms. Familiarity with healthcare claims data, audit processes, payment integrity concepts, and data mining approaches is strongly preferred, along with comfort partnering with technical teams and interpreting analytical outputs. Experience working in vendor-client delivery models is highly valued, as is demonstrated success managing budgets, headcount planning, and operational forecasting in a fast-paced, service-oriented environment.

What we offer

  • Work from anywhere in the US! Machinify is digital-first.
  • 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 

The salary for this position is based on an array of factors unique to each candidate: Such as years and depth of experience, set skills, certifications, etc. We are hiring for different levels, and our Recruiting team will let you know if you qualify for a different role/range. Salary is one component of the total compensation package, which includes meaningful equity, excellent healthcare, flexible time off, and other benefits and perks.

Equal Employment Opportunity at Machinify
 
We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace. Machinify is an employment at will employer. We participate in E-Verify as required by applicable law. In accordance with applicable state laws, we do not inquire about salary history during the recruitment process. If you require a reasonable accommodation to complete any part of the application or recruitment process, please let our recruiters know. See our Candidate Privacy Notice at: https://www.machinify.com/candidate-privacy-notice/

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