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Senior Director, Data Mining

Senior Director, Data Mining

Gainwell TechnologiesAny city, TX, US
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Summary

We are seeking a strategic and experienced leader for the role of Senior Director, Data Mining, responsible for overseeing ideation and validation of healthcare payment integrity data mining. This leader will manage a high-performing team to identify, test, and validate concepts that detect improper healthcare payments. The ideal candidate brings deep healthcare analytics expertise and a proven ability to lead teams, drive measurable results, and collaborate cross-functionally in a dynamic environment.

Your Role in Our Mission

  • Provide strategic direction and day-to-day leadership for the data mining team focused on uncovering and confirming data-driven audit opportunities.
  • Oversee the full data mining lifecycle from opportunity identification and concept design through validation, deployment, and post-audit analysis.
  • Apply knowledge of provider billing practices, claim adjudication processes, and regulatory requirements to guide development of actionable audit concepts.
  • Establish and track performance metrics to ensure teams meet productivity, quality, and financial objectives.
  • Collaborate with IT, Product and Client Services teams to refine, test, and operationalize audit concepts.
  • Lead documentation, knowledge sharing, and root cause analysis to inform ongoing audit development and provider education.
  • Mentor and develop managers and analysts to support succession planning and skill development across the team.
  • Represent the function in client meetings and executive-level discussions to articulate value, methodology, and results.

What We’re Looking For

  • Bachelor’s degree required (Healthcare Administration, Data Science, Business, or related).
  • Minimum of 10 years of experience in healthcare payment integrity data mining with at least 5 years in a leadership role.
  • Strong understanding of healthcare claims data, coding systems (ICD, CPT, DRG), and payment methodologies.
  • Demonstrated success in managing ideation and validation processes that produce measurable financial returns.
  • Skilled in SQL, Excel, and visualization / reporting tools; experience with SAS, Python, or similar tools preferred.
  • Excellent communication and presentation skills; ability to influence cross-functional stakeholders and executives.
  • Experience working in or with payer or provider organizations, government healthcare programs, or audit vendors.
  • Experience integrating AI / ML into data mining operations.

    • What You Should Expect in This Role

  • Home-based position with flexibility to work from anywhere in the continental US.
  • Must have a dedicated workspace and high-speed internet connection suitable for remote collaboration.
  • Requires availability during standard business hours for meetings and team interaction.
  • Occasional travel (up to 10%) for in-person team meetings or client presentations may be required.
  • This role may involve extended hours during high-priority initiatives or client deadlines.

    • The deadline to submit applications for this posting is August 29, 2025.

    The pay range for this position is $137,100.00 - $195,800.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a , and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.

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    Director Data • Any city, TX, US