Data Mining Specialist

Gainwell Technologies

. Act as Product Owner, Delivery Lead, and Implementation Manager for complex data mining and analytics initiatives .

Posted 9/18/2026full-timeRemote • United StatesSeniorLead💰 $99,200 - $141,700 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in Healthcare Payment Integrity and Data Mining, with a strong focus on AI-driven analytics and the ability to translate complex regulations into actionable solutions. Proven leadership in implementing advanced analytics techniques to enhance payment integrity and operational efficiency.

Highest-signal resume keywords

Healthcare Payment IntegrityData MiningAI/ML-Driven AnalyticsClaims Data ValidationRegulatory Compliance

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Data MiningAI-Driven AnalyticsPredictive ModelingAnomaly DetectionPattern RecognitionNatural Language ProcessingClaims AnalyticsAudit AlgorithmsAnalytic RulesReimbursement Methodologies

Soft Skills

Strategic LeadershipTechnical LeadershipCollaborationCommunication

Industry Keywords

Healthcare RegulationsCMS RegulationsState GuidelinesFederal GuidelinesCoding Standards

About the role

Key responsibilities & impact

Act as Product Owner, Delivery Lead, and Implementation Manager for complex data mining and analytics initiatives
Design, develop, and implement advanced data mining and AI-driven analytics concepts to identify overpayments and improper payments
Support and lead responses to client RFPs, contributing written content related to data mining, AI, and payment integrity capabilities
Translate healthcare regulations, reimbursement methodologies, and clinical policies into scalable audit algorithms and analytic rules
Lead incorporation of AI, machine learning, and advanced analytics techniques into payment integrity solutions
Provide strategic and technical leadership in designing, implementing, and scaling data mining and AI-enabled analytics solutions
Partner with engineering, clinical, operations, and client teams to deliver payment integrity solutions

Requirements

What you’ll need

7+ years of Healthcare Payment Integrity, Data Mining, or Advanced Analytics experience
Demonstrated experience in healthcare payment integrity data mining, including validation of claims data accuracy and payment accuracy
Experience applying CMS regulations, State/Federal guidelines, coding standards, and reimbursement policies to claims analytics
Strong experience translating business and policy requirements into technical and analytical solutions
Hands-on experience with AI/ML-driven analytics, such as predictive modeling, anomaly detection, pattern recognition, or NLP applied to healthcare or financial data
Video cameras must be used during all interviews and the initial week of orientation

Benefits

Comp & perks

Work flexibility
Learning and career development opportunities
Technical credentials and certifications
Generous, flexible vacation policy
Educational assistance
Leadership and technical development academies
401(k) employer match
Comprehensive health benefits
Occasional travel opportunities (0-10%)