The Technical Specialist role is aligned to our Content and Enablement group within the Coordination of Benefits (COB) team. This role will partner will various divisions and levels of leadership within the whole organization.   A Technical Specialist is accountable to internal customers in the pursuit of implementing new and recurring projects. Manages milestone and task execution within assigned projects and internal process improvement efforts. Directly works with product...

The Coordination of Benefits (COB) & Data Mining (DM) Audit Support is a member of the greater Coordination of Benefits and Data Mining Business Units (BUs.) This individual will efficiently and professionally handle daily administrative activities within the COB and DM departments to assist the audit to meet and exceed client expectations. This role requires exceptional verbal communication by audio as well as attentive attention to detail for data entry-related written communication and follow–ups for both internal and external client inquiries to achieve success in the generation of overpayments.

  This clinical analyst position will perform daily audits on client data for completeness and accuracy of coding utilizing both coding and clinical knowledge and background to ensure appropriateness for reimbursement and will also respond to provider appeals. Daily, substantive contact with internal staff. The formal title for this role is Coding Validation Analyst I but is staffed with RN's.   This is a closely monitored productivity-driven role and can be done anywhere in the continental US (this is shift work and hours need to be flexible...this team runs 24 x 7). Shifts include (after training): First,...

A Payment Accuracy 2, Data Mining (DM) Specialist, is a member of the greater Data Mining Business Unit (BU). Cotiviti's Data Mining team configures custom claim reviews to investigate untapped billing compliance issues specific to regulations and contracted policies across product, market, and provider types.   The Specialist 2, Payment Accuracy is responsible for developing new and existing audit concepts, gaining client acceptance, training all Specialist levels to execute audit projects, and evaluating the effectiveness of audit concepts.  Audits client data and generates high quality recoverable claims for...

The Technical Product Owner is responsible for driving solution definitions that support business ideas and product concepts at a team and program level through gathering and translating testable requirements into application software solutions. The Technical Product Owner has deep Healthcare domain knowledge, and strong experience in collaborating with a diverse team including product managers, software developers, testers, and teams such as Client Services, Operations, Clinical, Data Science, and Marketing. The Technical Product Owner also has experience working with Web Services and RDBMS Databases.

The Senior Manager - Engineering is responsible for serving as the strategic interface with assigned business units for the purpose of business/IT strategy planning, solution discovery, development, service management, risk management and relationship management. The Sr. Manager Engineering will work with multiple technical leads across projects. This person must have demonstrated the successful management of multiple development teams encompassing a total of 10-20 engineers where resources may be either onshore or offshore and can take diverse/changing requirements and turn them into actionable plans. This position will reward someone with a great vision with the opportunity to deliver it in a pragmatic...

Conducts and leads 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. Conducts executive briefings, consultations, educational sessions, and formal training for select strategic technologies. Supports technology and innovation strategy efforts in partnership with Business Unit technology leaders. Maintains a deep understanding of technology trends and hands-on experience with relevant technologies. Supports research and...

We are seeking an experienced and visionary vice president of data ingestion engineering to lead our engineering team and be responsible for one of the most critical products in our portfolio. Our data ingestion is a sophisticated data ingestion solution within the Cloudera ecosystem, responsible for processing 50% of the medical claims in the country. This role demands a leader with deep technical expertise in big...

The QA I, Clinical Ops position works with the Coding & Clinical Validation Audit team focused on risk coding. The QA position monitors & reports on the accuracy of all code captures on a % of all images of their assigned coders. This position also answers all questions for their coders through the Questions Queue or via email. QA is also responsible for assisting in the remediation for their coders which include full image review of all images coded prior to release to ensure accuracy of image, for any coder below project benchmark.

In the role of Concept Development Analyst within our Clinical Chart Validation organization, you will lead in the identification, creation, and implementation of innovative concepts within the healthcare billing and coding field. Drawing from your industry experience and knowledge of clinical practices and regulations, you will assist in the development of novel strategies to enhance our claim selection processes. Your proficiency in data analysis, organizational skills, and understanding of claim selection methods in conjunction with extensive knowledge of Medicare and Commercial payer requirements associated with Inpatient, Outpatient, and Physician based healthcare payment systems...

The Coding Manager leads a team of coders, directly or indirectly, to deliver key components to the Cotiviti coding program. This role works with the Director of Coding, the Client team and other areas related to production, QA, and analytics for oversight of ongoing production and quality accuracy.

The Power BI Developer collaborates with various team members and operational departments to develop internal and external reporting tools and gather/analyze requirements using industry best practices. They will work extensively in both ad-hoc and standard reporting packages and be involved in creating reports and dashboards that are scalable with large volumes of data.

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...

In the role of Concept Development Analyst within our Clinical Chart Validation organization, you will lead in the identification, creation, and implementation of innovative concepts within the healthcare billing and coding field. Drawing from your industry experience and knowledge of clinical practices and regulations, you will assist in the development of novel strategies to enhance our claim selection processes. Your proficiency in data analysis,...

Cotiviti is a leading solutions and analytics company that leverages unparalleled clinical and financial datasets to deliver deep insight into the performance of the healthcare system. These insights uncover new opportunities for healthcare organizations to collaborate to improve their financial performance, reduce inefficiency, and improve healthcare quality. The Software Engineer is responsible for the design and development of software applications and reusable software components for the Cotiviti Inc product suite, in compliance with predefined coding standards and technical design. This person will collaborate effectively...

The Product Manager (within Payment Accuracy Product Suite) will be responsible for product management and development supporting product growth.  This role will enhance and extend the Cotiviti product roadmap for our clients.  This role will serve as product subject matter expert working closely with stakeholders for product requirements, design and delivery.  Initially focused on our Dental product line, will grow into other areas.

As a Senior Database Admin, you will help drive team(s) in meeting project objectives. You are expected to contribute to and foster high performing technical teams. You will also be responsible for the design and coding of complex DB systems. You will collaborate and communicate effectively with architects, engineers, QA, DBAs, and Business managers to solve complex problems spanning their respective areas and...

This is a hunter role in the healthcare payer space. 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 in the Payment, Analytics or Population Health industry is also key. We are looking for candidates across the US.

The Product Manager will analyze market opportunities and define needs for analytics solutions across the Cotiviti enterprise, with a focus on Artificial Intelligence (AI). They will support a matrixed, shared service performing value and business case analysis for Enterprise Product and Business Unit Product teams. They will provide the business and product perspective and requirements to engineering and other departments within Cotiviti. This includes defining the problem to solve, quantifying the business value of a solution, and determining measures of success, along with communicating product workflows that enable ease-of-use for end users and documenting specific features and functions to improve and expand Cotiviti's analytics...

The Data & Insight Analyst is responsible for architecting and developing best-in-class and innovative analytics and reporting solutions. This role will have responsibility for establishing and sustaining processes and practices that support Big Data, Analytics, and Reporting solutions and applications in an Open Source environment. The Data & Insight Analyst should have a passion for data, working with business people, and creating solutions and driving innovation with a keen interest in mentoring and elevating other technical resources. This role will spend time working independently and as part of a team and will focus on specific deadlines in an Agile development process as defined by the...

Working in an agile software development environment, the Sr DevOps / CI-CD Automation Engineer is responsible for automating build-test-deploy lifecycle for wide variety of applications/services in the cloud. As part of the Advanced Solutions Group team, you will focus on enhancing platform services and contributing code to multiple automation projects. You will also utilize engineering and programming skills focused on enabling a DevOps model, participating with Architecture, Operations and Engineering teams within Agile processes. The role will include systems and solution design within the existing architecture, as well as design/implementation of improvements to meet business needs. The Senior DevOps engineer will work...

Cotiviti is currently looking to add an industry leading Data Scientist II, who is focused on machine learning solutions to join our Enterprise Data Science Team and build value-oriented, production level machine learning solutions.  This role is not for research-oriented data scientist, but rather should be of interest to those that want to apply their knowledge and experience to real world healthcare problems and seek to utilize machine learning and artificial intelligence to reduce the cost of healthcare and improve the management of healthcare. With access to dedicated on premise and cloud based big data solutions, this role will work with a vast amount of structured and unstructured data, including claims, membership,...

This auditing role will focus on Coding & Clinical Chart Validation for our Inpatient audits. The ideal candidate for this position needs to have both a clinical (nurse) and a coding / auditing background focused on the following disciplines from a coding and billing perspective: Inpatient DRG/APR-DRG. This position is responsible for auditing inpatient claims and documenting the results of those audits, with a focus on clinical review, coding accuracy, and the appropriateness of treatment setting and services delivered.

Cotiviti is currently looking to add an industry leading Data & Insight Analyst who is focused on architecting and developing best-in-class and innovative analytics, reporting, and support our AI/ML Center of Excellences. This role will have responsibility for establishing and sustaining processes and practices that support Big Data, Analytics, and Reporting solutions and applications. The Data & Insight Analyst should have a passion for data, working with business people, creating solutions, and developing causal relationships that fuel a data-driven culture. This role will involve working independently and as part of a team and will focus on specific deadlines in an...

Cotiviti is currently looking to add an industry leading Data Scientist I - ML, who is focused on machine learning solutions to join our Enterprise Data Science Team and build value-oriented, production level machine learning solutions.  This role is not for research-oriented data scientist, but rather should be of interest to those that want to apply their knowledge and experience to real world healthcare problems and seek to utilize machine learning and artificial intelligence to reduce the cost of healthcare and improve the management of healthcare. With access to dedicated on premise and cloud based big data solutions, this role will work with a vast amount of structured and unstructured data, including claims, membership,...

The Medical Director focused on Implementation & Sales is a key member of the Go To Market team. The role is to serve as a coding and medical payment policy subject matter expert (SME). This position is responsible for supporting the sales process for our Payment Policy Management and Clinical Validation lines of business, reviewing and presenting results of the Opportunity Analysis supporting sales, and presenting policy/directing the client toward appropriate policy adoption during the implementation phase.  The Medical Director will then transition the client to a Client Medical Director after approximately 30 days post...

The Data Scientist II - Generative AI will apply knowledge and experience to real world problems and seek to utilize their skills reduce the cost of healthcare and improve health quality and outcomes. 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...

We are seeking a highly motivated and detail-oriented Associate Data Scientist to join our innovative team. This entry-level role is ideal for recent graduates or individuals with limited experience in data science but with a strong passion for data and a keen interest in the healthcare industry. The Associate Data Scientist will work under the guidance of senior team members to support the development and deployment of data-driven solutions. If you are passionate about data and eager to solve complex problems, we encourage you to apply.

This role is part of the training team for the Clinical Chart Validation team. This position is responsible for improving the technical effectiveness of our teams by planning, developing, and delivering technical training, mentoring, and assessment. The individual will work collaboratively with subject matter experts in the Commercial & Government Audit Teams, Quality Assurance, Concept Development, and others to validate workflows and communication tools to enhance audit productivity, performance, and client satisfaction.

Cotiviti is a leading solutions and analytics company that leverages unparalleled clinical and financial datasets to deliver deep insight into the performance of the healthcare system. These insights uncover new opportunities for healthcare organizations to collaborate to improve their financial performance, reduce inefficiency, and improve healthcare quality.   The Senior Software Developer will work with core applications and database in the Payment Policy Management platform to help build and deliver features as a part of the team using SAFe practices. The...

Strategic Vendor Solutions ("SVS") provides support services to the entire Cotiviti, Inc. ("Cotiviti") organization for the contracting of vendors who provide products and services to Cotiviti as well as any vendors with potential to join Cotiviti's mission through a joint venture, product development or some other form of strategic partnership.   Cotiviti is a leader in analytics driven healthcare payment accuracy and quality-based solutions with locations in the USA, Canada, Australia, Nepal and India and relies heavily on leading edge technology to deliver these products and services to our wide range of customers. SVS is tasked with...

Cotiviti is a leading solutions and analytics company that leverages unparalleled clinical and financial datasets to deliver deep insight into the performance of the healthcare system. These insights uncover new opportunities for healthcare organizations to collaborate to improve their financial performance, reduce inefficiency, and improve healthcare quality. The Sr Software 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 senior developers, offshore development team members,...

The Senior Software Engineer - Full Stackwill work with core applications and database in the Payment Policy Management platform to help build and deliver features as a part of the team using SAFe practices. The developer will need to have strong healthcare background and be familiar with the domain. The developer will be focusing on one or more specific initiatives with the team. The developer will be responsible for implementing features for upcoming new initiatives while also making recommendations and improving the existing code base.   The developer...

The focus of the VP, Client Engagement is to develop and execute against growth, renewal and retention strategies on their customers within the top customer tier. The VP Client Engagement is accountable for the coordination and transparency needed to drive a successful, multi-pronged growth and retention strategy as well as a multi-level relationship engagement across the customer leadership team.

Cotiviti Retail audits purchases and payments related to merchandise inventories. We develop and prioritize an audit program to ensure value negotiated is value delivered, recommending actionable process improvements that help our clients improve the way they do business and mitigate financial loss from overpayments and under-deductions.    Too often, audits, contract reviews, and recovery efforts focus on one aspect of a retailer’s operations without considering how the business works as a whole. Cotiviti Retail works smarter and digs deeper, looking at a business from all angles to find sources of profit in unexpected places....

This is a technical role within Cotiviti’s IT Organization for a Jira and Confluence Architect. The ideal candidate will have a proven track record in designing, implementing, and managing Jira and Confluence Data Center products to meet complex business requirements. This role requires strong architectural expertise, hands-on experience, and the ability to optimize Atlassian products and secure Jira and Confluence environments.

A Product Manager is a key role within an assigned business unit that is responsible for the development, strategy, and performance of a specific product or product line. Plays a critical role in driving the success of a product by defining its vision, strategy, and execution plan, and collaborating with cross-functional teams to bring it to life.   Successful Product Managers possess a combination of technical expertise, analytical acumen, communication skills, leadership abilities, customer focus, strategic thinking, and collaboration skills. They play a critical role in driving the success of a product and delivering...

The Senior Data Scientist will join a highly skilled data science team and work directly with a talented team of software engineers, auditors, product managers and customer experience managers to analyse healthcare data and deliver value for our clients.

The Software Engineer is primarily responsible for the support and modernization of the existing proprietary designed IVR (automated cloud-native) software, and enhancement of other software components deployed in the Cotiviti product suite.

The Senior Auditor position is responsible for auditing client data on behalf of Cotiviti's clients and generating high quality recoverable claims for the benefit of Cotiviti and our clients. Responsible for conducting or assisting in the identification, validation, and documentation of moderate to more complex audit projects. Primarily responsible for mid to high auditing efforts by executing more independent projects assigned by the Audit Manager.

This is a hunter role in the healthcare payer space. 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 in the Payment, Analytics or Population Health industry is also key. We are looking for candidates across the US.