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Cotiviti, Inc. drives better healthcare outcomes through data analytics. This means taking in billions of clinical and financial data points, analyzing them, and then helping our clients discover ways they can improve efficiency and quality.
Learn more at www.Cotiviti.com.
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The Sr. Director of Payment Policy Management (PPM) Operations is responsible for overseeing the business operations within Cotiviti’s Payment business unit. This role plays a critical part in supporting sales, client engagement, business improvement, and operational processes. The Sr. Director will provide both strategic direction and team leadership, ensuring exceptional service for clients while positioning the organization for continued growth in alignment with business unit objectives. The ideal candidate will possess strong operational acumen, business transformation and people management skills.
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The Sr. Technical Program Manager is responsible for overseeing the development and execution of complex initiatives that require coordination of teams using a variety of software delivery practices, including SAFe. The Sr. Technical Program Manager collaborates closely with cross-functional teams to ensure projects are delivered on time, within budget, and meet the required quality standards.
Programs can involve simultaneous coordination across Business Units and Agile Release Trains as well as working with the following departments: the Executive Office, Finance, Operations,...
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At Cotiviti, we are custodians of data for our clients. Using their technical experience in ETL processes, Data Engineers ensure operational functions are occurring as expected. This includes but is not limited to managing data implementations, data integrations, data production, data quality, and data security.
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The Project Manager – Payment owns delivery of defined project(s) from initiation through close. Ensures plans are realistic, stakeholders are aligned, execution stays on track, and risks/issues are actively managed.
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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 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 and/or episode of care. 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.
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Cotiviti is seeking a forward-thinking Technical Architect to join the team. This is a high-impact, hands-on leadership role responsible for defining and governing the end-to-end technical architecture of a mission-critical Commercial & CMS audit platform — while simultaneously driving the platform’s AI-native transformation.
The ideal candidate brings deep enterprise architecture expertise, proven...
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The Senior Program Manager, Operations partners closely with assigned Client Executives and internal delivery teams to lead the execution, coordination, and ongoing delivery of Cotiviti’s Quality, Value‑Based Payment, and related platform solutions. This is a dedicated role serving as the primary day‑to‑day program lead for a strategic client and is accountable for overseeing all aspects of the client engagement across multiple products, teams, and workflows. The Senior Program Manager applies deep healthcare domain knowledge in Value Based...
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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.
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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 post-pay Fraud Waste & Abuse team.
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The Sr. Project Manager will be responsible for managing and coordinating multiple implementation projects within Cotiviti. This role will serve as the primary liaison between the Customer teams and the Cotiviti teams including implementation/delivery, Product and other relevant teams as necessary, ensuring that products/solutions delivered align with agreed upon Customer requirements and scope. The successful candidate will also be responsible for capturing Customer feedback, understanding the reasons behind any gaps, and managing the process to triage and resolve these gaps. The candidate will also lead or support the internal delivery teams from program coordination, communication, execution, and management standpoint.
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The Implementation Consultant assists in the testing and implementation of Edifecs’ solutions purchased by that client. The Implementation Consultant will generally be involved in installing & configuring under the direction of the Technical Project Manager and/or Implementation/Solution Architect. This includes installation of products on client hardware; configuration and development of programs, tasks and guidelines, and setup to fully implement an Edifecs solution. Duties can range from delivery of product training to new client specific requirements, development and deployment. The role involves client coordination and communication as well as technical...
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The Intern Technology Solutions Analyst is responsible for researching technologies and use cases for Cotiviti solutions. This internship role will report to the Director of Health Tech Research and work on Technical Prospecting within the Research and Development department. Technical Prospecting reduces investment risk and improves speed to value through early exploratory validation, development, and delivery of solutions. Portfolio Prospecting is tasked with maintaining transparency into the strategic environment and positioning Cotiviti with validated long-term pathways to competitive advantage.
Preferred location is South...
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The Director of Quality is responsible for ensuring quality delivery of the Payment Integrity Solution and driving excellence across multiple payment integrity products. This role will develop and implement a quality measurement framework, align quality processes across products, and establish monitoring mechanisms to communicate performance to senior leadership. The Director is focused on continuous improvement, delivering greater quality in support of Cotiviti’s growth strategy. Success in this role requires strong foundations in testing, technology, process management, operational acumen, and collaboration. The Director will engage with clients and internal teams to ensure the delivery of...
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Cotiviti focuses on improving the financial and quality performance of our clients. In healthcare, this means taking in billions of clinical and financial data points, analyzing them, and then helping our clients discover ways they can improve efficiency and quality.
Our software engineers enable insurance companies to identify risk associated within their membership population, allowing insurance companies to direct resources to members most in need.
If you are looking for an opportunity to lead software...
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Cotiviti focuses on improving the financial and quality performance of our clients. In healthcare, this means taking in billions of clinical and financial data points, analyzing them, and then helping our clients discover ways they can improve efficiency and quality.
Our software engineers enable insurance companies to identify risk associated within their membership population, allowing insurance companies to direct resources to members most in need.
If you are looking for an opportunity to lead software...
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Government & Policy Intelligence Manager monitors, analyzes, and communicates federal and state policy developments that impact Cotiviti's business and product portfolio. This role serves as an "outside-in" intelligence function, bringing legislative, regulatory, and policy insights into the organization to inform product strategy and commercial positioning. This is not a lobbying role; the focus is on intelligence gathering, analysis, and strategic communication to internal stakeholders.
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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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Cotiviti Healthcare is a leading provider of payment accuracy services to the most recognized companies in the healthcare and retail industries. We are seeking innovative thinkers and creative problem solvers who are interested in making a contribution to improving healthcare and want to be part of a team that is expanding rapidly and providing opportunities for career growth. If you want to make a difference and contribute to the improvement of healthcare payment integrity, consider an opportunity to join our healthcare recovery team as a Senior Payment Accuracy Specialist.
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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 post-pay Fraud Waste & Abuse team.
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Cotiviti is seeking a passionate and results-driven Technical Customer Solutions Manager to join our team and play a key role in driving long-term success for our clients through the effective use of Cotiviti products. In this strategic role, you will act as a trusted advisor to our healthcare payer clients, leveraging your deep operational knowledge of data processing systems, regulatory compliance, and enterprise system integration. Your expertise will help clients maximize the value of their Cotiviti investment while expanding our impact across the healthcare payer landscape. The ideal candidate combines strong technical acumen with a deep understanding of healthcare EDI operations, encounter data...
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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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We are seeking a passionate, talented, and enthusiastic AI Product Manager to join the AI R&D team and help build industry-leading AI technologies, enabling lines of business with cutting edge and impactful solutions. Not only would you accelerate the adoption of AI but also push the boundaries of advanced ML and Generative AI techniques at scale.
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The Policy Design Specialist role is responsible for managing health plan clients and executing monthly project requests. Perform policy configuration maintenance of current medical policies along with implementing new health plan medical policies per client request. Adhere to and remain in alignment with the most up to date healthcare industry medical coding guidelines. Perform data analysis to determine how to accurately apply coding updates and client requested customizations. Execute quality assurance checks to ensure appropriate claim editing recommendations are applied based on client request.
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The Senior Integration Solutions Engineer Level II will play a key role in building and supporting integration solutions within the company’s software ecosystem. This role requires close collaboration with clients, business teams, developers, and infrastructure providers to design and implement scalable, high-quality integrations that meet business needs. As a senior technical contributor, you will also mentor junior engineers, develop best practices, and ensure that integration processes are efficient, reliable, and aligned with the company’s goals. Additionally, you'll have the opportunity to research emerging technologies, enhancing integration capabilities and driving innovation.
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The Business Operations group works in small project teams to identify and address complex business challenges. The team operates like an internal consulting group to define and drive strategic, operational, and organizational improvements across the business.
Successful candidates will be self-motivated, intellectually curious, fast learners, comfortable with ambiguity and working independently, and able to focus on details while thinking strategically. He or she will have the ability to solve business problems of moderate scope and deliver insights that enable...
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The Program Manager, Operations will partner directly with the assigned Client Executive, retrieval, coding, and reporting team leads and will focus on the execution and delivery of the Cotiviti Risk Adjustment Products and Services for enterprise-level accounts. The Program Manager, Operations will directly own assigned accounts and is responsible for overseeing all aspects of our engagement for our Risk Adjustment solution set. The Program Manager, Operations will leverage their deep healthcare and project management knowledge to deliver the highest quality of services to Cotiviti...
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Cotiviti is seeking an Data Analytics Intern to join our healthcare data processing and AI team for Summer 2026. This internship focuses on analyzing Risk Adjustment healthcare data, performing Precision Recall (PR) calculations, and supporting AI/NLP innovation projects. You'll apply SQL and analytical skills to work with medical claims data, create business intelligence dashboards, and gain exposure to AI technologies including large language models and NLP systems. This is an excellent opportunity to combine data analytics expertise with cutting-edge AI applications in the healthcare domain.
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The Sr. Auditor, Quality Assurance position is responsible for ensuring that the audited claims meet quality standards necessary to generate high quality recoverable claims for the benefit of Cotiviti and our clients. Quality assurance emphasizes compliance with established procedures, accuracy of claim identification and supportive documentation. Identifies and notifies management of observed quality and communicates opportunities for process improvements based on independent audit claims review. Displays professional skepticism that enhances the work performed in order to achieve success in position.
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The Senior Retail Auditor position is responsible for developing new and existing audit concepts, gaining client acceptance, training all audit levels to execute audit projects and evaluating the effectiveness of audit concepts with the goal of auditing client data generating high quality recoverable claims for the benefit of Cotiviti and our clients. This specific position will entail multiple audit engagements per year to facilitate audit acceleration, process improvements, audit development, and new client onboarding.
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The Implementation Director will guide the delivery of services and technology to one or more clients by planning, supporting and / or managing implementation activities from pre-sales support through production verification.
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The AI-Native Product Lead is a team-embedded product role responsible for translating business needs into clear, testable, and technically actionable requirements and owning the product backlog for a single AI-Native team. This role serves as the product owner for the team, working closely with the AI-Native Tech Lead and engineers to ensure the team is focused on building valuable, usable, and high-quality software.
This role focuses on solution definition through requirements gathering, feature and user-story creation, backlog prioritization, and story acceptance, while operating within a small, focused team and...
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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 performance and stability of...
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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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Cotiviti is looking for a candidate to join our team as a Regional Vice President, Healthcare Payer Sales. This is a direct sales position with quota responsibility. The ideal candidate will be an articulate, high-energy, self-motivated sales professional with a minimum of 10 years’ experience selling enterprise software solutions to the health insurance industry. If a candidate has experience selling B2B, middleware, data transformation solutions, business intelligence software, or Risk Adjustment that’s a plus. The Regional Vice President, Payer Sales will be responsible for managing all Health Care sales activity for key accounts—growing Cotiviti's revenues and client base in this territory.
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The Sr. Enterprise Process Specialist is tasked with driving large, cross-discipline, company-wide process improvement and operational projects with high executive visibility. These projects include improving operational efficiency and reducing cycle times, international operations and offshoring, deployment of new systems, and other projects as directed. As each improvement project is different, the expectation is to utilize a variety of tools, approaches, and formal methodologies to successfully complete the outlined objectives and may or may not...
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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 post-pay Fraud Waste & Abuse team.
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The Vice President, Business Development – Government Healthcare is responsible for devising and executing the strategy for new business opportunities and customers in the Federal Government Healthcare market and in the State Government Healthcare market. This role will drive increased revenue through new contract awards in the Federal Government Healthcare market for the Veterans Administration, Defense Health Agency, and/or the Centers for Medicare and Medicaid Services, and as appropriate other Federal/State Agencies. This position is responsible for activities in the full business development / sales cycle for Government procurements, to include:...
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The Business Systems Analyst role is aligned to our Content and Enablement team within the Enterprise of Data Mining and Yield Management. This role will partner will various divisions and levels of leadership within the whole organization.
A Business Systems Analyst will work alongside Technical Specialists, Analysts, Content and Datameer Managers as well as external departments including any level of leadership to collaborate in achieving the goals established by the department and organization. Knowledge of product management, healthcare and experience as an Agile Product Owner will be critical for success of this role...
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Cotiviti Healthcare is a leading provider of payment accuracy services to the most recognized companies in the healthcare and retail industries. We are seeking innovative thinkers and creative problem solvers who are interested in making a contribution to improving healthcare and want to be part of a team that is expanding rapidly and providing opportunities for career growth. If you want to make a difference and contribute to the improvement of healthcare payment integrity, consider an opportunity to join our healthcare recovery team as a Payment Accuracy Specialist 2.
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This senior sales leadership role is responsible for building, developing, and leading a high-performing team of field sales executives focused on selling Cotiviti’s Retail & Commercial Payment Accuracy solutions—including SaaS-based prevention platforms such as ZHA—to Retail and Commercial organizations across the U.S. The ideal candidate brings extensive experience leading sales teams, deep relationships with senior retail executives, and a track record of selling complex analytics, audit, payment integrity, and SaaS solutions to enterprise-level retailers.
Experience calling on retail C-suite leaders,...
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At Cotiviti, we are custodians of data for our clients. Using their technical experience in ETL processes, Data Engineers ensure operational functions are occurring as expected. This includes but is not limited to managing data implementations, data integrations, data production, data quality, and data security.
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The Sr. Security Engineer - IAM is responsible for designing, implementing, and maintaining privileged access solutions to secure critical systems and accounts. This role focuses on managing privileged credentials, enforcing least privileged principles, and ensuring compliance with organizational and regulatory standards. The Sr. Security Engineer - IAM works closely with InfoSec, IT operations, and application teams to deploy and optimize the Delinea PAM solution.
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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....
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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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A GTM role dedicated to the development of enterprise and client-specific sales renewal strategies and contract execution to ensure favorable contract terms and conditions and capture growth.
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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 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.
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This auditing role will focus on Coding & Clinical Chart Validation for our Inpatient audits (DRG Validation). 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...
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The Research Medical Director is a key member of the Clinical and Policy research development area at Cotiviti. The Research Medical Director is responsible for providing leadership guidance to the clinical teams and ensuring the Rules and policies are accurately interpreted and developed. This role is also responsible for analyzing, interpreting, and developing additional policies that will allow us to enhance our medical policy library. The Medical Director will guide both internal and external processes as related to Payment Policy Management polices and rules.
This is a...