The Senior Manager, Quality Assurance leads a team of quality-focused individuals across multiple review types responsible for developing, executing, and continuously improving CCV’s quality assurance programs, and ultimately, delivering value to our clients. This leader oversees the governance of quality standards, criteria, audit guidelines, and monitoring processes to ensure programs are evaluated, maintained, and refined over time. The Senior Manager is responsible for ensuring the accurate application of audit guidelines applied through AI-supported and human-reviewed processes, to support high audit accuracy, consistent and sustainable review outcomes, and reliable identification of quality opportunities. Grounded in Cotiviti’s values—Deeply Curious, People Obsessed, Make it Count, and Build it Better—the Senior Manager fosters a culture of inquiry, accountability, collaboration, and continuous improvement. This role will also focus on incorporating innovation and AI into the QA program to make it more proactive and effective in identifying, prioritizing, and closing vulnerabilities. The role is expected to move beyond reporting results to proactively identify emerging risks, influence corrective action, and confirm measurable, sustained improvement across AI-supported and human-reviewed workflows. The Senior Manager serves as a business partner to operational leaders while fostering alignment among key stakeholders across CCV operations, concept development, machine learning and strategic analytics, and client service teams.  

AI-Enabled Quality Program Governance

• Owns and matures the quality program framework, including quality controls, sampling strategy, escalation routines, governance cadence, and sustained monitoring.
• Defines, measures, and monitors accuracy, consistency, and decision quality across AI-supported and human-reviewed workflows.
• Identifies early quality signals, accuracy drift, and client-facing or operational exposure before issues escalate externally, using root cause analysis, trend monitoring, and risk segmentation to determine whether issues are isolated, systemic, or likely to affect our clients.
• Partners consultatively with operations, analytics, technology, training, and client-facing leaders to translate quality findings into action.
• Develops remediation plans that include containment, ownership, timelines, measurable success criteria, governance checkpoints, and evidence of sustained improvement.
• Ensures changes to AI-supported workflows are supported by controlled pilots, release-readiness criteria, risk-based testing, documentation, post-implementation monitoring, and stakeholder alignment.
• Champions innovation and responsible use of AI to creatively improve audit performance, increase review effectiveness, strengthen quality insights, and identify scalable opportunities to improve accuracy, productivity, risk detection, and client value.
• Drives continuous improvement by establishing clear accountability, ensuring disciplined execution of quality actions, and positively influencing auditor and audit behavior through data-driven coaching, feedback loops, reinforcement of expectations, and sustained monitoring of outcomes. Communicates emerging risks and remediation progress clearly to senior leadership with appropriate urgency, balance, and action orientation. 

• Bachelor’s degree in related field required; Bachelor’s degree with a quality, healthcare, or analytical focus preferred - quality management or health administration preferred, but may also include statistics, mathematics, industrial engineering, or computer science (focus in data management and analysis). 
• 3+ years of technical leadership experience: people and projects.
• AI-native experience using generative AI applications such as Claude, Microsoft Copilot, or similar tools to improve analysis, workflow efficiency, communication, decision support, and quality program execution.
• AI accuracy mindset: understanding of validation, exception review, quality drift, and human-in-the-loop controls, with the ability to translate these into measurable accuracy improvement. Consultative influence: uses data and business context to influence teams and drive corrective action without creating defensiveness.
• Proven experience influencing behavior, reinforcing expectations, and driving adoption of process, quality, or performance improvements across audit teams.
• Remediation execution: builds practical remediation plans with clear owners, milestones, measurable success criteria, and follow-through.
• Executive communication: able to communicate complex quality and risk concerns in a concise, balanced, and leadership-ready manner, with appropriate urgency.
• Advanced knowledge of Excel (Pivot Tables, Macro's, V Lookups, queries, advanced written formulas). 
• Strong analytical and problem-solving ability.  
• Organizational skills. 
• Attention to detail and accuracy. 
• Desire and capacity to learn new concepts and software.  
• Excellent written and verbal communication skills. 
• Experience in a HIPAA-regulated environment. 
• Comfortable speaking in front of a group, with clients, and working with physician executives.   Professional with ability to properly handle confidential information.  
• Ability to work well independently and in a team environment.  
• Ability to handle multiple tasks, prioritize and meet deadlines.  
• Ability to mentor staff and enhance performance.
• Skilled in root cause analysis, trend monitoring, and risk segmentation to distinguish isolated issues from systemic or client-impacting trends.  

Preferred Skills  

• Experience with quality management methodologies (e.g., Six Sigma, Lean, or CAPA) is a plus. 
• Experience developing or maintaining quality assurance programs, audit methodologies, or quality monitoring systems is a plus. 
• Knowledge of medical reimbursement/payment policies, audit review methodologies, and medical terminology is a plus.