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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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The Cotiviti Retail Business Process Optimization (BPO) Team is seeking a Manager to work closely with our operations, R&D, and client teams. We are looking for an individual who is a self-starter, interested in developing their own skills and experiences as well as being a trusted go-to resource for other BPO team members. We are looking for an individual who is technically sound but also curious and interested in learning our unique and results oriented business. This individual must possess a complete understanding of retail audit recovery work, best practices for managing audit teams, great interpersonal skills and be comfortable with conducting...
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Cotiviti is seeking a Director, Business Architecture to build and lead the Business Architecture capability for the Payment Integrity business unit. This role will define how the business needs to work to support scale, reduce fragmentation, improve business-to-technology alignment, and enable more efficient execution across the operating model.
This leader will clarify business capabilities, value streams, ownership, decision paths, and target-state operating models; identify redesign opportunities; and create the foundation for automation, AI enablement, innovation, and scalable transformation. The role requires a strategic leader who...
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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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The Senior Counsel, Partnerships will be the main legal resource overseeing strategic partnership contracting. The role will also support the Director, Senior Corporate Counsel in overseeing the full life cycle of Cotiviti’s healthcare and non-healthcare vendor contracts – from initial negotiation through execution, ongoing management, renewal, and termination. This role will be responsible for reviewing, drafting, and negotiating a broad range of commercial agreements, including master services agreements, license agreements, SaaS agreements, business associate agreements, non-disclosure agreements, and other related commercial agreements. The ideal candidate will have...
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In the role of Concept Development Analyst (CDA) within our CCV business unit, you will support the enhancement and ongoing optimization of claim selection processes and tools, including AI-enabled methodologies. This role is primarily focused on applying deep clinical, coding, analytical, and reimbursement expertise to strengthen and operationalize existing selection strategies.
Leveraging your knowledge of inpatient billing, you will contribute to improvements in proprietary claim selection tools that drive accurate, compliant, and scalable payment integrity outcomes. Your understanding of healthcare payment methodologies, coding behavior, and reimbursement...
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This is a senior hunter sales role responsible for selling Cotiviti’s Pharmacy Claim Editing and Payment Accuracy solutions to U.S. health plans, third-party administrators, and self-funded plan sponsors. Target customers include national and regional commercial health plans, Blues plans, Medicaid Managed Care Organizations, Medicare Advantage and Medicare Part D plans, payer-owned PBMs, Third-Party Administrators (TPAs), and administrators of self-funded employer health plans.
The role requires deep experience selling complex healthcare software and...
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The Director of Solution Innovation Strategy leads early-stage solution strategy and innovation shaping for emerging healthcare opportunities. This role identifies, frames, and advances high-value solution concepts at the intersection of healthcare business needs, operational realities, market direction, and enabling technology. The role is translational in nature: it is not a pure product role, pure research role, or pure technology strategy role. Instead, it bridges what is technically possible to what is strategically useful,...
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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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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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This is a senior hunter sales role focused on selling Cotiviti’s Dental Claim Accuracy solutions to Dental Benefit Administrators (DBAs) and Health Plans that administer dental benefits. Target customers include organizations such as Delta Dental Plans, MetLife Dental, Guardian, Cigna Dental, Aetna Dental, UnitedHealthcare Dental, Blue Cross Blue Shield plans with dental lines of business, and regional dental administrators.
The role requires extensive experience selling complex healthcare software and services into dental payer organizations, with demonstrated success...
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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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This internship centers on researching and developing advanced healthcare informatics solutions with a specialization in Agentic AI—AI systems capable of autonomous reasoning, decision-making, and goal-directed behavior. The intern will explore applications of Agentic and Generative AI in healthcare, supporting improvements in treatment, payment, and operations. You will play a key role in developing, analyzing, and collaborating on
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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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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 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 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 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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The Sr Gen AI Data Scientist I - 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...
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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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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 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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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 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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The Security Engineer - IAM role plays a crucial part in IT security, by ensuring that the right individuals have appropriate access to technology resources. They manage and maintain the IAM infrastructure, monitor user access activities, and implement policies to safeguard sensitive information. The Security Engineer - IAM collaborates with other departments to design, configure, and support secure access systems, ensuring compliance with regulatory requirements. Their role involves continuously evaluating and improving security measures to protect against unauthorized access and potential data breaches.
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This is a Senior Auditor, Team Lead, with responsibility for supervising a team of Clinical Validation Auditors or other audit team members. Team Leaders ensure that the work of others meets productivity standards, quality guidelines and audit efforts of the client engagement. Primary responsibilities include queue management, work distribution, performance and production optimization, audit planning, auditor interactions, training of new hires/existing staff, Audit Report and Claims writing and support of audit closure activities. The Senior Auditor goal is to ensure the team audits client data on behalf of our clients, generating high quality recoverable claims. Displays professional skepticism that...
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The AI-Native Technical Architect II provides advanced architectural leadership within an assigned business area, aligning solution development with broader architecture direction while remaining closely connected to implementation.
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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 production, data quality, and data security.
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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...
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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 Integrity space is required with specific experience selling Coordination of Benefits and/or Data Mining solutions being highly desired. We are looking for candidates across the US.
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The Sr Staff AI Scientist- 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,...
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Working in an agile software development environment, the 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...