Gainwell Technologies · 2 hours ago
Data Mining Content Ideation Project Management
TX
Full-time
Onsite
Senior Level
$108K/yr - $155K/yr
7+ years expGainwell Technologies LLC is a company dedicated to improving the health and well-being of vulnerable populations through advanced technologies. The Data Mining Content Ideation Project Management role involves providing strategic and technical leadership in designing and implementing analytics solutions that enhance claims accuracy and identify improper payments in healthcare. This position requires collaboration with various teams to ensure the delivery of high-impact solutions while adhering to regulatory guidelines.
Health CareInformation Technology
Responsibilities
Act as Product Owner, Delivery Lead, and Implementation Manager for complex data mining and analytics initiatives within the Systems Integration group
Design, develop, and implement advanced data mining and AI-driven analytics concepts to identify overpayments and improper payments across medical, dental, and pharmacy claims
Support and lead responses to client RFPs, contributing superior written content related to data mining, AI, and payment integrity capabilities
Translate complex healthcare regulations, reimbursement methodologies, and clinical policies into scalable audit algorithms and analytic rules
Research and apply CMS regulations, State and Federal guidelines, coding standards, and industry best practices to claims data and payment integrity initiatives
Lead the incorporation of AI, machine learning, and advanced analytics techniques (e.g., anomaly detection, predictive modeling, NLP, pattern recognition) into payment integrity solutions
Partner with data science and engineering teams to ensure AI solutions are explainable, auditable, compliant, and operationally scalable
Ensure AI-driven solutions align with regulatory requirements, client policies, and ethical AI standards
Act as Product Owner, Delivery Lead, and Implementation Manager for complex data mining and analytics initiatives
Serve as a senior mentor and subject matter expert, guiding and developing analysts, content designers, and project team members
Partner with clinical, operations, appeals, validation, and client services teams to resolve production issues and support ongoing audits
Drive continuous improvement of audit processes, analytics, and delivery methodologies
Qualification
Required
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
Proven 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
Ability to articulate AI-driven insights clearly to technical and non-technical stakeholders
Benefits
Generous, flexible vacation policy
401(k) employer match
Comprehensive health benefits
Educational assistance
Leadership and technical development academies
Company
Gainwell Technologies
Gainwell Technologies is a provider of Information Technology & Services. It is a sub-organization of Veritas Capital.
10001+ employees
H1B Sponsorship
Gainwell Technologies has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (90)
2024 (78)
2023 (56)
2022 (96)
2021 (33)
Funding
Current Stage
Late StageTotal Funding
$1M2023-06-06Grant· $1M
Leadership Team
Paul N. Saleh
President and Chief Executive Officer
Gary Call
Chief Medical Officer
Recent News
bloomberglaw.com
2025-12-12
GlobeNewswire
2025-12-11
Company data provided by crunchbase