Manager, Commercial Data Mining - Remote

Plymouth, Minnesota (United States) Overview As Operations Manager for Commercial Data Mining, you drive initiatives to optimize data-driven audits of provider payments and identify root causes of overpayments. You will shape processes that improve data quality, accelerate recoveries, and support budgeting and strategy with cross-functional partners. You'll help build scalable workflows and client relationships, contributing to safer, more efficient healthcare payments. This role blends hands-on analytics with operational leadership to deliver measurable value for clients and the business. You will work remotely within the U.S. with a collaborative, impact-focused team culture. Compensation / Benefits comprehensive benefits package incentive and recognition programs equity stock purchase 401k contribution remote work options telecommuter policy Responsibilities Ensure timely data acquisition and accuracy Maintain ideation pipeline Prioritize and manage audit production efficiency Drive timely recoveries Assist in strategic planning and budgeting Effectively communicate with, manage, and develop staff Provide reporting and attend meetings with internal and external stakeholders Support internal quality assurance efforts Key requirements 4+ years of healthcare, health insurance, payer operations, claims, payment integrity, or related experience 2+ years of experience with healthcare coding guidelines, reimbursement policies, and payment methodologies 2+ years of experience communicating with business stakeholders, clients, or leadership Proven understanding of healthcare claim adjudication and payer workflows Demonstrated understanding of EDI data, including 837 claim submission and 835 payment/remittance data Demonstrated ability to work independently and manage multiple priorities through completion Proven knowledge of healthcare payment methodologies Demonstrated proficiency in Microsoft Office software client engagement presentational skills leadership and staff development EDI data (837/835) healthcare claim adjudication payer workflows