Technical Architect provides architectural leadership and guidance in their assigned business area, aligning solution development efforts with the broader architectural vision and roadmap. A Technical Architect’s skills and knowledge must include multiple domains (Application/Solution architecture, Technical/Infrastructure architecture, Information/Data architecture), and experience with relevant implementation technology, platforms, and tools. As a leader, a Technical Architect is expected to influence the assigned organization and work independently with senior business and IT leaders, while acting as a mentor and role model within the development teams. The Technical Architect is accountable for successful implementation of...
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.
The Technical Specialist role is aligned to our Content and Enablement team focusing on Content Optimization. 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 managers and internal cross-functional counterparts to ensure timely and quality output of project...
The Senior Technical Specialist role is a key contributor to our Content and Enablement team, playing a crucial role in supporting the Payment Integrity Business Unit. This position collaborates with various divisions and leadership levels across the organization.
The Senior Technical Specialist role will be responsible for working with Product Owners and Technical Architects to define project scope, technical direction, and project milestones. You will have responsibility for working with other stakeholders to define business requirements, acceptance criteria and non-functional...
The Technical Project Manager will be responsible for leading Infrastructure-related projects as well as assisting teams to complete day-to-day workloads. They will partner with various other teams at Cotiviti, including Research & Development and Client Implementations to deliver client centric projects. The IT Project Manager will also contribute to continuous improvement of work management processes to ensure the most efficient delivery of Infrastructure requests. This person will also assist in tracking hardware purchases through internal finance processes to final delivery of equipment. They will report to the Project Management Lead and will be...
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...
The Senior Program Manager will partner directly with the assigned Client Engagement Lead, clinical, coding, and reporting team leads and will focus on the execution and delivery of the Cotiviti Prospective Payment Products and Services for an enterprise level account. The Senior Program Manager will directly own and manage enterprise level account activity and is responsible to oversee critical aspects of our engagement for our Prospective Payment solution set. The Senior Program Manager will leverage their deep healthcare, analytics and project management knowledge to deliver the highest quality of services to Cotiviti clients.
Cotiviti is currently looking to add an industry leading Data Scientist I QA, 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...
A 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.
As a Revenue Cycle Specialist, this position is responsible for handing basic level work of recurring and/or daily functions and processes that are necessary for business execution. Under the direct supervisor of the Team Lead, a Revenue Cycle Specialist will be required to...
We are looking for an Recovery Resolution Specialist (Collections) to join our Yield Management team! This role will facilitate the collection of funds for the client and maintains exceptional provider relations. Works closely with audit team, payers and providers to understand claims and or concepts to facilitate effective communication and collection. Engages in verbal and written communication involving the provider, audit staff and client. Identifies problems in the collection process for escalation to the appropriate parties.
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. This individual will develop Strategic account plans for their assigned accounts and work closely with Operations teams to ensure execution against those plans....
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.
The Coordination of Benefits (COB) & Data Mining (DM) Audit Support is a member of the greater Coordination of Benefits and Data Mining teams. 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 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.
Provides day-to-day supervision and direction to assigned audit team. Ensures operations are running optimally and processes and procedures are being followed. Ensure appropriate staffing levels, and plan and organize workloads and staff assignments according to the needs of the audit. Manages the overall performance, productivity and quality assurance of the assigned audit team. Maximizes opportunities of the audit; optimizes timely audit processes and efficiencies. Involved in formulating all budget related aspects of the audit. Executes and adjusts to budget demands. Drives the profitability of the audit engagement.
Cotiviti is seeking a passionate and results-driven Customer Program 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, revenue recognition, audit compliance, and risk adjustment. Your expertise will help clients maximize the value of their Cotiviti investment while expanding Cotiviti’s impact across the healthcare payer landscape.The ideal candidate combines strong technical acumen with a deep understanding...
We are seeking a skilled and proactive Strategic Sourcing Specialist to join our strategic sourcing team. The ideal candidate will have a background in sourcing, supplier management, or purchasing. This role requires an analytical thinker with the drive for continuous improvement in our sourcing processes.
The Itemized Bill Review (IBR) Program Manager oversees and leads IBR business operations including claim workflow, vendor performance management, inventory management, and timely and accurate completion of client deliverables. This role entails implementing strategy, tracking milestones and performance, communicating progress, removing obstacles, gaining alignment, escalating issues as needed, and delivering results on time. In addition, this role is responsible for adhering to contractual commitments and delivering customer satisfaction consistent with Cotiviti and client policies and procedures.
Provides day-to-day supervision and direction to assigned Contract Compliance audit team. Ensures operations are running optimally and processes and procedures are being followed. Ensure appropriate staffing levels, and plan and organize workloads and staff assignments according to the needs of the audit. Manages the overall performance, productivity and quality assurance of the assigned audit team. Maximizes opportunities of the audit; optimizes timely audit processes and efficiencies. Involved in formulating all budget related aspects of the audit. Executes and adjusts to budget demands. Drives the profitability of the audit engagement.
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.
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.
This new and evolving position includes diverse responsibilities such as assisting with the alignment in the Outpatient Specialty (OPSP) policies across Commercial and Government and assisting with project work by leveraging skills in Excel, Visio, and PowerPoint, and coordinating with other departments.
The Project Manager will also analyze various data sources and offer and help implement ideas for process improvement. This role will help to identify efficiencies during the development, testing and initial production...
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 a Provider Services Analyst.
This role is a...
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...
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 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.
What does it mean to be a Payment Accuracy...
The Sr. Vice President, Corporate Controller, is responsible for providing overall direction of the Company’s accounting, internal control, finance shared services and audit activities. This position is responsible for the enhancement, development, implementation, and enforcement of policies and procedures that will improve the overall operation, effectiveness, and control environment of the organization. The Sr. Vice President, Corporate Controller, will also manage a variety of accounting functions including accounts payable, accounts receivable, general ledger, revenues and expenses, and assets, liabilities,...
The Program Director is responsible for the successful delivery of Cotiviti services to client(s). Responsible for delivery of Cotiviti services to Government client(s) in accordance with client contract requirements. Oversees routine delivery of client services, and responsible for day-to-day management of client relationship and overall contract P&L. Must have strong project management capabilities and assist in scope expansion and implementations. Must track to strategic corporate initiatives that are tied directly to individual account goals and objectives. Strong communicator and collaborator with IT leaders. Strategic thinker and innovator.
The Trainer Consultant of Implementations is responsible for providing effective and relevant training to our clients through online, in person and recorded sessions. This is achieved through evaluating the Training Request, communicating with the client and the internal support team, and utilizing tools and techniques to deliver on the objectives. They will apply different forms of technology to measure the success of the training and make updates to the strategy based on the results.
We are seeking a highly skilled and experienced Staff Engineer I to join our dynamic team in Payment Integrity. The ideal candidate will play a crucial role in leading and mentoring a team of Senior Software Engineers, while working closely with the Leadership and Principal Software Engineer(s) to drive technical excellence and innovation. This position requires a deep understanding of software development, software development practices, strong leadership abilities, and a passion for solving complex technical challenges.
The Policy Integration Coordinator I position holds the primary responsibility for ensuring that each client’s initially chosen policy set & tables have been configured accurately based on the client’s decisions. Manages lower complexity projects. This includes copy of existing payer data, E&M over code, and payer termination projects.
Also loads table mappings for Clinical Chart Validation projects. The Policy Integration Coordinator I provides technical support related to payment policies to the Implementation MD, Implementation Service...
The Medical Review Manager (MRM) is responsible for coordinating the components of Clinical Chart Validation (CCV) reviews across audit staff, content staff, and associated processes. The MR Manager shall have broad knowledge of the CCV program and working knowledge of all non-Recovery Audit (RAC) lines of business requirements and activities. The MR Manager shall be responsible for keeping abreast of regulatory, policy, and coding changes as well as clinical practice, coding rules, and technology changes that may result in improper payments.
The Fraud, Waste & Abuse (FWA) Content Solutions Analyst is a key member of the clinical operations and content team responsible for the research, development, and quality assurance, associated with new FWA conditions. In addition, this position will be responsible for review and analysis of current conditions and assisting in the research necessary to ensure conditions stay current.
Join Cotiviti's Talent Acquisition team and support our hiring efforts! This role will provide administrative support to the Recruiting team in the delivery of the highest level of recruiting service execution to Cotiviti. You will be instrumental in supporting the coordination of candidate/Hiring Manager/Recruiter schedules for complex or multi meeting assessments activities, providing administrative support for hiring activities, completing and administering associated new hire paperwork and processes, production of defined reporting / metrics, maintenance of appropriate talent pipeline / preferred supplier / key contact lists, and any other related recruiting support as required. Bilingual English/Spanish preferred to assist with...
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.
Sr. Implementation Consultant is a post-sales position that focuses on individual clients and implementing Cotiviti solutions purchased by that client. The Consultant will generally be involved in installing, configuring, and overseeing the implementation of Cotiviti products at client sites. This includes installation of products on Cotiviti or client hardware; configuration and development of programs, tasks and guidelines, to fully implement an Cotiviti solution based upon a client’s specific needs. The Implementation Consultant will be the primary Professional Services technical resource and will interface with the client’s technical resources. Duties can range from delivering product...
The Senior Attorney supports the VP, Associate General Counsel, advising on artificial intelligence, data rights, technology, and intellectual property issues that impact the company's operations. The position will play a vital role in the Company’s growth by providing strategic legal advice, supporting business operations, and influencing future innovation in the rapidly evolving fields of AI, technology, and data governance. The ideal candidate will possess experience with data rights and AI technology systems and an understanding of privacy rights as it applies to data analytics and technology in the healthcare industry. The candidate will be responsible for advising on solutions that help our clients improve the quality of...
The Implementation Consultant is a post-sales position focused on individual clients and the implementation of Cotiviti's solutions they have purchased. This role involves installing, configuring, and overseeing the implementation of Cotiviti's products at client sites. Responsibilities include installing products on Cotiviti or client hardware, and configuring and developing programs, tasks, and guidelines to fully implement Cotiviti solutions based on the client's specific needs. The Implementation Consultant will serve as the primary technical resource for Client Services, interfacing with the client's technical...
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 Senior Software Engineer is responsible for the design and development of software applications and reusable software components for the Cotiviti, Inc. (Retail) product suite, in compliance with predefined coding standards and technical design. You will be required to collaborate effectively with senior developers, QA, product owners, project management, and other internal stakeholders.
This is a hands-on technical role to support our Retail audit team through client data conversion and the support, development, and delivery of audit tools and reports. Ideal candidate combines experience with Microsoft Access application development...
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 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.
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...
The Corporate Strategy Associate is member of the Corporate Development and Strategy team at Cotiviti. This person will be responsible for supporting the company’s annual strategic planning process, assisting with new product market research and business cases, and performing analysis and research across a variety of strategic topics. Reporting to the Vice President of Corporate Development and Strategy and working in partnership with Product Leads, the Corporate Strategy Associate will provide support for revenue growth pursuits within and across Cotiviti product areas, supported with analytical rigor.
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.
The Cotiviti Retail division are seeking an experienced Manager, Engineering to lead our engineering team and work closely with Retail operations. 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 architecture software strategies 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.
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 solution requirements. They have deep knowledge of domain and strong experience in collaborating with diverse teams including product managers, software developers, testers, and teams such as Client Services, Operations, Clinical, Data Science, and Marketing.
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...
The Senior Data Product Manager drives the discovery, design, development, and implementation of highly scalable analytic tools 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, data analysts, and data scientists to develop analytic tools that inform decision-making and accelerate growth. This role also drives the implementation of product management best practices / tools, leads the development of data-driven thought leadership, and mentors junior team members.