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This is a sales leader role focused on leading at team of field sales executives selling Cotiviti’s Health Enablement (Risk Adjustment and Quality) solutions in the healthcare payer space. Experience leading sales teams is required as is extensive experience calling on and selling to Health Plan “C” level executives, SVP Business Owners, procurement, VPs and directors is essential. Experience working in a leading Health Plan software and service vendor selling Payment Accuracy solutions including claim editing, data mining, coordination of benefits, clinical chart validation and/or fraud, waste and abuse detection is also key. We are...
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The Product Manager plays a strategic and executional role within the business, responsible for leading product development, strategy, and performance within an assigned business unit. This role ensures the successful launch and ongoing management of a product or product line by aligning business needs with customer expectations. This position will drive product ideation, execution, and stakeholder alignment while balancing customer needs with business objectives. The successful Product Manager will effectively commercialize a new product at launch to gain market adoption and revenue growth.
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We are looking for a Revenue Cycle Specialist to join our Yield Management team! This role is responsible for the reconciliation and posting of all payments received, identify discrepancies and analyze issues to ensure all payments are posted timely. Other responsibilities include managing inventory and system alignment between Cotiviti and our clients, reconciling data between different sources, research, and the ability to work with cross-functional teams.
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The Records Processing Agent processes incoming and outgoing mail containing medical records and requests for records as well as document reproduction while maintaining production and quality levels through tracked metrics.
This is an ONSITE POSITION at our Blue Bell, PA location. This is a TEMPORARY POSITION for 4 months.
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Join a dynamic team at Cotiviti Healthcare where innovation meets impact! We're revolutionizing healthcare payment accuracy and seeking passionate professionals who want to transform the industry. If you're a creative problem-solver ready to drive meaningful change and accelerate your career, this is your moment to shine!
This role is responsible for training, leading and daily oversight of Revenue Cycle Specialists, as well as the knowledge share and refinement of Revenue Cycle processes. This includes daily communications with the client and Claim Audit personnel, as well as...
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The Senior Director Product Management is a strategic leadership role responsible for driving the vision, strategy, and execution of a Cotiviti’s Consumer Engagement product portfolio. This position leads and mentors product managers and analysts, collaborating cross-functionally to deliver innovative solutions that meet market demands and business objectives.
The Senior Director Product Management will ideally have experience with health care quality measurement and reporting (NCQA HEDIS, Star Ratings, etc.), Risk Adjustment, and closing gaps within these domains via member engagement. The successful Senior Director Product Management will be comfortable using AI to develop product features in an...
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The Client Services Manager (CSM) is responsible for coordinating the cross-functional client team and is focused on achieving plans with clients, revenue retention, and client satisfaction and growth for the Prospective Payment PPM and CV products. The CSM serves as both internal and external client liaison accountable for triaging, managing, monitoring and support of client related activity. The CSM builds and sustains client relationships, achieves the client’s recognition of Cotiviti as a partner, and ensures client success with...
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We are seeking a highly accomplished Principal AI Process Specialist to lead enterprise-critical process improvement initiatives that drive strategic growth and operational transformation. Looking for a senior leader with a proven track record of delivering significant process improvements with financial impact of seven to eight figures.
The Principal AI Process Specialist will lead cross-functional digital transformation and process...
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Director, Product Management for value-based payments is a senior leadership role responsible for overseeing, developing, and executing the product strategy for the business. This role typically involves a combination of strategic thinking, team leadership, and hands-on involvement in product development and lifecycle management.
In this role, using subject matter expertise and market insights, you will support the current solution/product offerings and will be instrumental in guiding the development of new product offerings, delivering value with existing customers, and driving revenue opportunities. You will work with current clients...
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As VP Product, Interoperability, you will own and execute Cotiviti’s market strategy, product roadmap and commercial growth for health plan interoperability — extending our leading industry position and expanding our impact into broader payer / provider collaboration. You will bring unique insight into payer priorities, challenges, and blind spots; prioritize market needs; run competitive analysis; engage experts within and outside our organization; and lead product launches that expand our client value proposition and advance Cotiviti’s market position. Hands-on knowledge of payer administrative processes and payer / provider interoperability is essential, along with a genuine passion for solving hard problems and...
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The Sr. Support Engineer plays a critical role in providing advanced technical and functional support for Smart Trading solutions, including Transaction Management, XES, and related trading and post-trade processing platforms. The role is responsible for triaging complex production issues, leading critical incident management efforts, and ensuring timely resolution of customer-impacting problems.
The ideal candidate is a proactive and highly motivated professional with strong analytical and troubleshooting capabilities, proven experience supporting enterprise applications in production environments, and the ability to work effectively...
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We are seeking an experienced Manager, Engineering- AI to lead our data engineering team. This individual will play a crucial role in overseeing the development of strategic perspectives regarding IT architecture and business needs. The Manager of Engineering will develop and implement data architecture and engineering strategies leveraging innovations in AI while exemplifying strong software development experience when working in an Agile environment. This individual will provide guidance to employees in accordance with established policies and management directives.
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This auditing role will focus on Coding & Clinical Chart Validation for our Inpatient audits. The ideal candidate for this position needs to have a coding/auditing background focused on Inpatient DRG Coding from a coding and billing perspective. This position is responsible for auditing inpatient DRG and documenting the results of those audits with a focus on coding accuracy and the appropriateness of treatment setting and services delivered.
This role...
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This auditing role will focus on Coding & Clinical Chart Validation for our Outpatient and Specialty audits. The ideal candidate for this position needs to have both a clinical (nurse) and a coding / auditing background focused on one of the following disciplines from a coding and billing perspective: SNF, IRF, Home Health, APC, ER, Diagnostics and Professional Service. This position is responsible for auditing outpatient/specialty claims and documenting the results of those audits. with a focus on clinical review, coding accuracy, medical necessity, and the appropriateness of treatment setting, and services delivered.
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We are looking for a Revenue Cycle Specialist to join our Yield Management team! This role is responsible for the reconciliation and posting of all payments received, identify discrepancies and analyze issues to ensure all payments are posted timely. Other responsibilities include managing inventory and system alignment between Cotiviti and our clients, reconciling data between different sources, research, and the ability to work with cross-functional teams.
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Join a recently formed team focused on Model Risk and Responsible AI. The Senior GenAI Scientist II – Risk will apply knowledge and experience to real world problems and seek to utilize their skills to reduce the cost of healthcare and improve health quality and outcomes. As a Data Scientist on this team, you will focus on three main project areas: Model Validation, Model Metrics and Monitoring, and Responsible AI. This requires someone with depth in
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A Senior Revenue Cycle Specialist is a member of the Revenue Cycle team within the Yield Management Division. This department may work directly with other members of Yield to ensure department expectations are accomplished. The Sr. Specialist, Revenue Cycle position is responsible for complex levels of recurring and/or daily functions and processes that are necessary for business execution; including but not limited to, ensuring the quality of various functions within the department (check application, offsets, invoicing,...
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The Sr. Revenue Integrity Analyst owns advanced revenue analysis and key month-end controls that support accurate invoicing, revenue application, inventory reconciliation, revenue cycle processes, and financial reporting within the complex chart review business function. This role investigates revenue leakage, applies revenue, manages revenue SLAs, analyzes inventory and financial variances, and leads resolution of invoice and client issues. The role develops actionable reporting, partners across functions to correct root causes, and mentors junior analysts.
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The Sr. Revenue Integrity Analyst owns advanced revenue analysis and key month-end controls that support accurate invoicing, revenue application, inventory reconciliation, revenue cycle processes, and financial reporting within the complex chart review business function. This role investigates revenue leakage, applies revenue, manages revenue SLAs, analyzes inventory and financial variances, and leads resolution of invoice and client issues. The role develops actionable reporting, partners across functions to correct root causes, and mentors junior analysts.
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As an AI Program/Project Manager, you will play a pivotal role in driving the development and deployment of innovative AI/ML solutions. You will collaborate closely with cross-functional teams, including engineers, data scientists, and business stakeholders, to identify, prioritize, and deliver high-impact AI/ML products. You are data driven and influence our business strategy and technical priorities with that vision. This role will drive alignment between data
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The Marketing Business Operations Specialist supports the Corporate Affairs organization by helping maintain the operational infrastructure that keeps the marketing function organized, efficient, and scalable. This role supports vendor and technology inventory, contract and SOW tracking, renewal coordination, procurement and invoice support, license and utilization tracking, vendor performance monitoring, SharePoint administration, process documentation, and cross-functional operational requests. This is a growth-oriented opportunity for a highly organized, detail-oriented individual to learn the marketing function, build business operations expertise, and develop a career path within Marketing Operations, Business Operations,...
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The Implementation Manager is accountable for the operational execution of the project plan for new customers or new projects specific to existing customers. They will partner with the client services organization to meet client expectations and revenue goals, as well as with any/all internal departments in support of the plan execution to include IT, product, product development, operations, finance, and training. They will define and lead the creation of project implementation project plans, identify process improvement opportunities,
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The Staff Gen AI Scientist will apply knowledge and experience to real world problems and seek to improve health quality outcomes and reduce the cost of healthcare. With access to dedicated on premise and cloud based big data solutions, the team can work with a vast amount of structured and unstructured data including claims, membership, physician demographics, medical records and others to begin to solve some of the most pressing healthcare issues of our time. A Data Scientist at Cotiviti will be given the opportunity to work directly with a team of healthcare professionals including analysts, clinicians, coding specialists, auditors and innovators to set...
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The Principal IAM/PAM Security Architect defines and evolves security architecture for identity and privileged access across a large, complex, multi-domain environment spanning Active Directory, Microsoft Entra ID, and Okta, as well as cloud-native identities across AWS, Azure, GCP, and OCI.
This role sets security standards for each identity environment, leads the definition of emerging Agentic Identity standards for AI agents and other non-human identities, defines requirements for and drives implementation of the Delinea PAM platform, and owns secrets governance...
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The Artificial Intelligence Governance, Director provides enterprise-wide oversight, coordination, and visibility for Cotiviti’s AI governance framework, ensuring consistent documentation, responsible AI use, regulatory readiness, and ongoing post deployment compliance monitoring across all business units.
The position operates with significant autonomy at the Enterprise level to develop and oversee enterprise AI governance standards, compliance reporting mechanisms, and evidence collection processes, while ensuring business units retain ownership, accountability, and responsibility for...
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Provide technical and operational support to enterprise customers by resolving product-related issues and delivering high-quality customer experience. Mentor Product Support and Product Operations teams, collaborate with Implementation and Development teams, and support release activities through testing, validation, performance analysis. Collect, analyze, and document critical information required for accurate problem diagnosis and resolution.
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The Vice President, Sales is responsible for the development and strategic execution of annual sales plans to support the acquisition of new clients and sale of new solutions for the Cotiviti Retail division. This is a hunter role focused on hunting new business for Cotiviti’s Retail Payment Integrity Services and Solutions to the world’s largest retailers, e-commerce, and commercial enterprises. Demonstrated experience calling on and selling to “C” level executives, SVP Business Owners, CFO’s, Procurement, VPs, and Directors is essential. Experience working in a disruptive software and services sector selling Data Analytics, Payment Integrity / Recovery Auditing services and...
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The Sr. Support Engineer is primarily responsible for the support of the existing software applications and enhance software components deployed in the Cotiviti product suite. The successful candidate will be required to collaborate effectively with other developers, offshore development team members, business owners, project management, and other internal stakeholders.
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The Senior Support Analyst will assist in monitoring, analyzing and resolving data platforms, configuration, and infrastructure related issues. This person serves as a liaison between technical and operation teams. This position provides analysis and problem solving, technical assistance and support coordination to business stakeholders. The person will make decisions based on independent judgement to resolve a range of complete technical problems. The Senior Support Analyst needs strong analytical skills and the ability to think outside the box when the root cause...
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The Senior Support Analyst will assist in monitoring, analyzing and resolving data platforms, configuration, and infrastructure related issues. This person serves as a liaison between technical and operation teams. This position provides analysis and problem solving, technical assistance and support coordination to business stakeholders. The person will make decisions based on independent judgement to resolve a range of complete technical problems. The Senior Support Analyst needs strong analytical skills and the ability to think outside the box when the root cause...
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The Senior Support Analyst will assist in monitoring, analyzing and resolving data platforms, configuration, and infrastructure related issues. This person serves as a liaison between technical and operation teams. This position provides analysis and problem solving, technical assistance and support coordination to business stakeholders. The person will make decisions based on independent judgement to resolve a range of complete technical problems. The Senior Support Analyst needs strong analytical skills and the ability to think outside the box when the root cause...
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The Generative AI Research Engineer Intern conducts primary and secondary research of advanced and emerging healthcare informatics technology with a focus on Generative AI and emerging Artificial General Intelligence technology for healthcare treatment, payment, and operations use cases. Creates research papers, analytical reports, proposals, and educational material. Maintains a deep understanding of technology trends and hands-on experience with relevant technologies. Develops generative AI models, architectures, databases, and systems to improve healthcare solutions.
We are currently looking for interns...
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A Revenue Cycle Specialist 2 is a member of the Revenue Cycle team within the Yield Management Division. The Specialist 2 is responsible for moderate to complex levels of recurring and/or daily functions and processes that are necessary for business execution. This would include the reconciliation and posting of all payments received, identification of discrepancies, and analyzed issues to ensure payments are posted timely. Other responsibilities will include processing invoices, managing large sets of inventories and the ability to process electronic requests in multiple systems and platforms.
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The Sr. Technical Product Owner (STPO) is responsible for driving solution definitions that support
business ideas and product concepts that can be turned into application software solutions. The STPO
works at a team, program, and enterprise level, gathering needs and translating those into testable
requirements.
The STPO has deep domain knowledge and strong experience in collaborating with a
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The Product Marketing Director owns go-to-market strategy and execution for an assigned solution area within Cotiviti's portfolio. This particular individual contributor role will support our Quality, HEDIS and Stars solutions by working directly with our Product, Operations and Sales/Client Engagement teams.
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As a Medical Reviewer, you will be auditing medical records to evaluate the accuracy of medical coding and health plan policies for our Fraud, Waste & Abuse clients.
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The Clinical Consultant support Clinical Services teams in the validation of quality and processes consistency on the CPE editing engine.
Provides support and subject matter expertise on Coding Validation (CV) to both clients and internal stakeholders during the planning, implementation, go-live, transition to operational team, and through the duration of the contract. Clearly understands and articulates CV concepts and policies. Collaborates with internal teams to provide meaningful input on CV...
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As a Senior Investigator, you will investigate suspected incidents of healthcare fraud, waste, or abuse through data analysis (a high level of proficiency with Excel is required). This is not a physical investigator role.
This role aligns with our pre-pay Fraud Waste & Abuse team.
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Cotiviti is consolidating several client-facing portals into one unified Client Performance Portal — spanning executive, analyst, and operations views, and covering SLA reporting, benchmarking, case detail, enhancement requests, roadmap visibility, regulatory insights, and billing self-service. One module already exists in production (Support/ticketing, built on Blazor/.NET, Azure PaaS, Okta, and Jira) and will be folded in rather than rebuilt from scratch.
We're...
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As a member of the Corporate legal team, you will provide exceptional legal services to internal business units by responding to routine matters and questions in a timely manner. You will also review, draft and negotiate various contracts, but not limited to business associate agreements and statements of work. Additional responsibilities include contracts library research, administration, review of regulatory agreements and answering inquiries on RFPs.
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The Enterprise Marketing Director executes marketing initiatives that support Cotiviti's established enterprise narrative and brand positioning under guidance from marketing leadership - work that spans every portfolio rather than belonging to one. This role supports development and deployment of enterprise messaging assets and campaign materials aligned with approved messaging frameworks, supports Cotiviti presenters in analyst relationships and executive briefings, and synthesizes competitive and market signal into the corporate story. Unlike a portfolio-aligned Director Product Marketing role, this position has no assigned solution area: its scope is the company's story as a whole.
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The Product Manager (within Payment Accuracy Product Suite) will be responsible for product management and development supporting Cotiviti payment integrity prospective products Payment Policy Management (PPM) and Coding Validation (CV). This role is dedicated to creating and optimizing products that enhance and expand the Cotiviti payment integrity services for our clients. This role will serve as a product subject matter expert working closely with stakeholders to drive product requirements, design, and successful delivery.
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The Content Solutions Analyst I is a key member of the clinical operations and content team responsible for the research, quality assurance, and opportunity analysis associated with new medical policies. In addition, this position will be responsible for review and analysis of current medical policies and assisting in the research necessary to define additional logic and algorithms to expand the Cotiviti payment policy library.
The Content Solutions team works within Payment Policy Management and supports all of our PPM Solutions: outpatient, inpatient,...
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This role provides senior-level technical engineering and troubleshooting support for enterprise clients running hybrid environments that span legacy Windows and Linux systems and Kubernetes-based infrastructure. Responsibilities center on root-cause analysis of complex, multi-tier defects - reproducing issues in controlled environments, engineering fixes, and validating them through automated test suites.
The role also carries direct ownership of delivery infrastructure: building and maintaining CI/CD pipelines (Jenkins, GitLab CI, or Azure DevOps),...
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The Data Governance & Analytics Architecture Director is a leader within the Health Enablement Analytics organization responsible for ensuring all data, analytics, and AI initiatives are built on a scalable, standardized, and governed foundation. This role serves as a subject matter expert for data governance, analytics architecture, and AI/ML best practices across Health Enablement. This role provides advisory leadership, technical guidance, and architecture standards to ensure analytics and innovation efforts are aligned to enterprise data strategy and built in a scalable, sustainable manner.
This position operates as a...
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The Senior Manager, Audit Manager Training leads the design, delivery, and continuous improvement of training and capability-building programs for audit managers and quality audit staff across CCV. This leader owns the curriculum that prepares auditors and audit managers to apply audit guidelines accurately and consistently, including training on AI-supported review tools, human-in-the-loop workflows, and the judgment required to validate AI-assisted findings. The role partners closely with Quality Audit Operations, concept development, machine learning and strategic analytics, and client service teams to translate evolving audit guidelines, quality findings, and...
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The Client Policy Manager I manages client payment policies by ensuring client’s payment policy is accurate, up-to-date, and complete; executes client-specific requests with guidance from internal team and acts as the internal and external client team liaison.
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A Lead Solution Consultant will play a pivotal role in driving Cotiviti’s growth by combining deep technical expertise with strong pre-sales acumen across the healthcare payer landscape. This is a client-facing role requiring the ability to lead technical discovery, perform detailed assessments, and design solution architectures aligned to payer business and IT environments.
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The Senior Technical Specialist will collaborate closely with the RCA - Content & Enablement Department, the Implementations Team, and the Audit Operations and R&D teams. This role is responsible for the intake, logic development, deployment, and maintenance of Business Rules that support RCA’s platform applications. The Specialist will also lead efforts to identify and remediate technical limitations, design advanced exclusions logic, and support operational scalability through strategic rule development.
In addition to driving rule implementation, the Senior Technical Specialist will act as a key liaison between the operations team and the BRMS...
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We are seeking a highly experienced Principal AI Engineer to lead the architecture, design, and development of a cutting-edge agentic framework and centralized AI platform that serves as the foundation for the organization's AI initiatives. As the technical lead for the Risk Adjustment (RA) Coding Agent, you will own the end-to-end technical architecture—from clinical NLP integration and production routing to core AI platform components that enable...