The Client Medical Policy Manager 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.

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

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.

The Product Director will drive strategy for Cotiviti’s Payment Integrity Client platform product roadmap. This individual will have responsibility and leadership for understanding and prioritizing market needs, performing competitive analysis, performing product discovery, supporting design, delivering business cases and leading delivery and commercial product launches for new products and capabilities

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 6 months. 

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.

The Product Director will drive strategy for Cotiviti’s Payment Integrity Client platform product roadmap. This individual will have responsibility and leadership for understanding and prioritizing market needs, performing competitive analysis, performing product discovery, supporting design, delivering business cases and leading delivery and commercial product launches for new products and capabilities

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.

As a Senior Systems Engineer you will be responsible for resolving escalated service issues, coaching other engineers to resolutions, engineering and implementing complex projects, and for maintaining and overseeing the technology of their assigned areas. This includes VMWare, Windows, and Linux environments.   We are seeking a highly skilled Senior F5 Engineer with a proven track record in enterprise-scale application delivery, load balancing, and secure traffic management. This role requires deep expertise in F5 BIG-IP LTM, iRules...

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.

A Senior Revenue Cycle Specialist is a member of the Revenue Cycle team within the Payment Integrity area of Cotiviti. This department may work directly with other members of Yield to ensure expectations are accomplished. The Sr. Specialist position is responsible for complex levels of recurring and 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, etc.). Other responsibilities will include solving complex issues that have been identified and being a point person for other Revenue Cycle Specialists within the department. A Senior Specialist will...

This role is located in Mexico and can be fully remote if the selected candidate is based outside of a commutable distance to our Mexico City office.   We are seeking an experienced Business Intelligence (BI) Developer to lead the design, development, and optimization of scalable BI solutions that empower our teams and customers with data-driven insights. The BI Developer II will be responsible for developing self-service dashboards, automated reports, extracts and other highly scalable analytics that deliver data-driven insights to customers.  This role implements best...

This role is located in Mexico and can be fully remote if the selected candidate is based outside of a commutable distance to our Mexico City office. We are seeking an experienced Senior Data Engineer to join our multidisciplinary data product team. This role plays a critical part in architecting, developing, and optimizing scalable data pipelines, enabling advanced analytics and machine learning (ML) solutions across the organization. As a Senior Data Engineer, you will design and implement robust...

The Data Product Manager drives the discovery, design/development, and implementation of highly scalable analytic products including self-serve BI dashboards, AI/ML models, automated reports, and curated datasets.  This role owns the voice of the customer and partners with data engineers, BI developers, and data analysts/scientists to develop data products that inform decision-making and accelerate growth.  The Data Product Manager is passionate about harnessing the power of data to inform decision-making and developing analytic tools that drive business value. 

The Senior Solution Architect is responsible for creating best-in-class business offerings. This is accomplished through collaboration with business leaders, sales and support teams, and client conversations. The Senior Solution Architect will have responsibility for establishing and sustaining processes and practices that support present and future sales and implementations, ensuring sales are aligned with current technical offering and capabilities, and that custom client requests are substantiated and well understood. The Senior Solution Architect should have a passion for helping others understand our technical solutions and architecture, creating well defined...

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,...

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...

The Data Scientist II - AI/ML 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 set...

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.

We are seeking a senior developer to join our dynamic team. The developer will be responsible for designing, developing, and maintaining software applications using Microsoft Power Platform. The ideal candidate will have significant working experience with all of these Microsoft technologies: Power Apps, Power Automate, AI Builder, Azure AI Studio, Co-Pilot and DataVerse as well as proficiency in one other language, such as Python.

The Manager of Revenue Cycle is a member of the Revenue Cycle team within the Yield Management Division of our healthcare data analytics company, where we support health plans with their revenue optimization. This department may work directly with other members of Yield to ensure department expectations are accomplished.   The Manager, Revenue Cycle position is responsible for providing leadership and management for one or more accounts or significant audit support projects. Oversee audit support revenue cycle activities for assigned account to maximize valid claim identification...

The Principal 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 Director of AI - Risk - 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. The opportunity includes to work directly with a team of healthcare professionals including analysts, clinicians, coding specialists, auditors and innovators to set aggressive goals and...

The Sr Data Scientist - Generative AI II will apply knowledge and expertise to real world problems to enable healthcare organizations to deliver better care at lower cost through advanced technology and data analytics, helping to ensure the quality and sustainability of how healthcare is delivered in the United States. 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...

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...