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Payment integrity and claims data mining

nineDots.io
Posted: 22h ago
Offer description

A rare opportunity to build something properly from the ground up. This is a brand new senior leadership hire in Dublin, tasked with shaping a US healthcare claims exploratory intelligence capability from first principles.
About the organisation
A global data and AI business listed on NASDAQ, employing over 60,000 people across six continents. They partner with major insurers and healthcare organisations, helping them improve payment integrity, reduce leakage, and apply analytics where it actually makes commercial sense. The Dublin office is expanding, with this role acting as the beachhead hire for a centralised exploratory intelligence function.
What you’ll do

Build and lead an enterprise exploratory data mining strategy focused on US healthcare claims leakage, overpayments, and anomalous billing behaviours across Medicare, Medicaid, Behavioural Health, and Commercial lines
Reverse-engineer claims outcomes to uncover root causes such as adjudication gaps, configuration issues, workflow behaviours, and provider patterns
Translate exploratory findings into structured, analytics-ready concepts and business requirements for downstream Data Science and Technology teams
Lead and grow a small cross-geo team (US and India initially), establishing governance, validation standards, and clear concept prioritisation based on risk and recovery value

What you need

Deep, hands‑on US healthcare claims expertise across Medicare, Medicaid, and Commercial environments (this is non‑negotiable)
A proven track record identifying payment leakage, inappropriate billing, and systemic adjudication gaps through exploratory investigation
Experience acting as the bridge between operations and analytics, converting domain knowledge into scalable analytical concepts
Senior leadership credibility, with the ability to influence clients and internal stakeholders through clear, commercially grounded storytelling

SQL knowledge is useful but not essential. Domain depth and payment integrity credibility will outweigh pure technical tooling every time.
The practical bits
Bonus: 15%
Band: D2 senior management
Location: Dublin (hybrid, 2–3 days in office)
Eligibility: You must already have the right to work in Ireland. No sponsorship available.
This role reports to the VP of the function and comes with partial P&L exposure, though budget ownership remains at VP level. You’ll start with two to three direct reports across the US and India, with clear scope to scale the Dublin team as the capability proves its commercial value.

Round 1: Deep dive on US claims domain expertise and payment integrity experience
Round 2: Managerial and strategic discussion with the VP and geo leaders
Final round: HR and organisational fit

All interviews are conducted remotely via Teams. No presentations required.
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