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 Client Medical Director (CMD) is a key member of the Go To Market team. Along with the Client Engagement Leader, the CMD co-captains the team serving the Prospective Payment Management (PPM) client team at the health plan. The CMDs role is to serve as a coding and medical payment policy subject matter expert (SME). The CMD is responsible for directing the Medical Policy Committee (joint committee with health plan MD, coding experts, and payment integrity). The CMD will develop a relationship with the client, review their data, select medical policy to present, serve as SME for clinical and coding expertise, and back end support for the client’s Medical Director. The CMD will evolve as the trusted advisor for the Health Plan...

A Payment Accuracy, Coordination of Benefits (COB) Specialist, is a member of the greater Coordination of Benefits Business Unit (BU). Coordination of Benefits involves situations in which an individual is covered by two or more health plans. Our specialists are passionate about what they do and are experts at reviewing, discovering, and validating substantial amounts of data and delivering results and insights for our clients. A Payment Accuracy, COB Specialist, is responsible for reviewing and analyzing claims, member, and group data to identify instances of recoverable claims for the benefit of Cotiviti...

Cotiviti is currently looking to add an industry leading Data Scientist II who is focused on machine learning solutions to join a revolution in Healthcare Technology and build value-oriented, production level machine learning solutions. This role is not for the research-oriented data scientist, but rather should be of interest to those that want to apply their knowledge and experience to real world problems, and seek to utilize Artificial Intelligence and Machine Learning to

The Sr AI Product Manager - We are seeking a passionate, talented, and enthusiastic individual to join the AI R&D team and help build industry-leading AI technologies, enabling lines of business with cutting edge and impactful solutions. You will lead the strategy, development, and lifecycle of data products that power GenAI solutions across the enterprise. This role bridges the gap between data engineering, AI teams, and business stakeholders to deliver high-impact, reusable data products.

The Sr. Technical Product Owner is responsible for driving solution design and definition that support business ideas and product concepts at a team, program, and enterprise level through ideating, gathering, refining and translating product vision and requirements into application software solutions. The Sr. Technical Product Owner has deep domain knowledge, and strong experience in collaborating with a diverse cross-functional team including Product Managers, Solution and Enterprise Architects, User Experience Designers, and teams such as Client Services, Operations, Clinical, Data Science, and Marketing. Sr. Technical Product Owner’s are accountable to facilitate and drive Design Driven...

We are looking for a UX Designer that has a proven track record of leveraging design thinking and user feedback to design experiences that are delightful and motivating. The ideal candidate will be motivated about user-centered design and be able to thrive with minimal process and direction while driving efficiency, consistency and results with cross-functional teams. If you also have a portfolio of professional design projects that includes work with web/mobile applications, we’d like to visit with you.

Join a recently formed team focused on Model Risk and Responsible AI. The Senior GenAI Scientist II – Risk will apply knowledge and experience to real world problems and seek to utilize their skills to reduce the cost of healthcare and improve health quality and outcomes. As a Data Scientist on this team, you will focus on three main project areas: Model Validation, Model Metrics and Monitoring, and Responsible AI. This requires someone with depth in

This auditing role will be responsible for performing retrospective clinical chart reviews on Readmission and Place of Service Claims by utilizing nationally accepted guidelines, clinical review judgment and review methodologies specific to the contract for which services are being provided. This involves accessing proprietary systems to audit medical records, applying critical thinking and decision-making skills, and accurately documenting a rationale with the findings and supporting references. The ideal candidate for this role would be a Registered Nurse with experience in utilization or case management.  

As a Senior Manager of Engineering, you will oversee all operational aspects of software development, ensuring projects are completed on time and within scope. You will provide administrative, technical, and people leadership for multiple, diverse, and geographically distributed teams. Your responsibilities will include providing clear guidance, delivering constructive feedback to team members, and promoting a culture of continuous improvement and innovation.   This is an exciting opportunity to make a significant impact on our organization and contribute to the advancement of healthcare data analytics....

This auditing role will focus on Coding & Clinical Chart Validation for our Outpatient and Specialty audits. The ideal candidate for this position needs to have both a clinical (nurse) and a coding / auditing background focused on one of the following disciplines from a coding and billing perspective: SNF, IRF, Home Health, APC, ER, Diagnostics and Professional Service. This position is responsible for auditing outpatient/specialty claims and documenting the results of those audits. with a focus on clinical review, coding accuracy, medical necessity, and the appropriateness...

This auditing role will focus on Coding & Clinical Chart Validation for our Outpatient and Specialty audits. The ideal candidate for this position needs to have both a clinical (nurse) and a coding / auditing background focused on one of the following disciplines from a coding and billing perspective: SNF, IRF, Home Health, APC, ER, Diagnostics and Professional Service. This position is responsible for auditing outpatient/specialty claims and documenting the results of those audits. with a focus on clinical review, coding accuracy, medical necessity, and the appropriateness of treatment setting, and services delivered.

The Quality Analyst (SW Development) is responsible for executing on quality assurance efforts, driving automation, and improving testing processes for complex software systems. This role requires technical expertise with databases, data pipelines and data stores, expertise with test automation, quality metrics, and performance testing. The Quality Analyst works closely with software development and product teams to ensure high-quality software and data pipelines, collaborates closely with other QA team members, and executes on initiatives to enhance testing efficiency and effectiveness across the organization.

Technical Product Owner (TPO) will serve as a critical bridge between product management, stakeholders, and agile development teams. The TPO will ensure technical implementation aligns with overall business vision and strategy, guiding product development, managing technical aspects, and ensuring product features meet user needs and technical feasibility. This role requires a strong technical background, particularly in Enterprise Data Warehousing and Business Intelligence, and the ability to translate technical requirements into actionable development plans. The ideal candidate will act as a technical resource, address technical debt, and drive technical solutions that support business...

Accountable to internal customers in the pursuit of implementing new and recurring projects. Manages milestone and task execution within implementations projects and internal process improvement efforts. Works directly with implementation managers and internal cross-functional counterparts to ensure timely and quality output of project deliverables including but not limited to data analysis, forecasting, reporting, performance metrics and other operational functions. Maintains project status and issues / risks in the applicable...

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....

The Sales Enablement Manager is a member of the Global Retail Go-to-Market (GTM) team and reports to the VP, Client Engagement. The GTM team is focused on: 1) driving quality growth, 2) accelerating sales productivity, and 3) generating revenue.   The Sales Enablement Manager (SEM) partners with and supports members of the Go-to-Market and Audit Operations teams to support the cultivation and expansion of client relationships, and to enroll new business prospects, to drive top...

A Senior 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. The Sr. Specialist, Revenue Cycle position is responsible for complex levels of recurring and/or 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,...

The Staff Gen AI Scientist will apply knowledge and experience to real world problems and seek to improve health quality outcomes and reduce the cost of healthcare. 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...

The Business Product Owner - Content & Enablement (C&E) 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.   The Business Product Owner (within Payment Policy Operations) will be responsible for leading technology product roadmaps supporting Research operational processes as the business lead working closely with a wide group of...

Join a recently formed team focused on Model Risk and Responsible AI. The Staff GenAI Scientist - Risk will apply knowledge and experience to real world problems and seek to utilize their skills to reduce the cost of healthcare and improve health quality and outcomes. As a Data Scientist on this team, you will focus on three main project areas: Model Validation, Model Metrics and Monitoring, and Responsible AI. This requires someone with depth in

We are seeking an experienced Lead Software Engineer to design and lead the development of a scalable, high-performance FHIR Repository service capable of handling hundreds of terabytes of healthcare data. This system will form the foundation of our next-generation healthcare data platform — powering interoperability, analytics, and compliance across our product ecosystem.   You will be responsible for the architecture, design, and implementation of core services that store, retrieve, and manage FHIR resources at massive scale. The ideal candidate combines deep technical expertise in database scalability, distributed systems, and...

The purpose of the MIPS (Medical Image Processing) Agent is to review and associate medical records to the appropriate requests while maintaining adequate production and quality levels through tracked metrics.   This is a REMOTE Position and TEMPORARY for up to 6 months.  The schedule may require a Tuesday through Saturday commitment. 

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 role will primarily support provider escalations related to Cotiviti's prepayment FWA services.  This is not a physical investigator role.

Provide architecture and design for integrating Edifecs solutions into customer environment to meet customer business needs and technical needs for performance, scalability, maintainability and availability. Mentor implementation consultants and review work products/designs delivered by implementation consultants to ensure that they meet prescribed architecture. Provide software code and other artifacts for complex scenarios. Interface with Edifecs engineering team to understand product reference architecture and convert it into implementation architecture templates. Provide guidance to partners who are implementing Edifecs solution from time to time. Troubleshoot critical and complex issues in production that are escalated by support...

We are seeking a highly experienced Principal Data Architect to lead the design and implementation of our next-generation cloud data platform, enabling advanced analytics and AI/ML solutions in the healthcare domain. This role will be responsible for end-to-end data architecture, including infrastructure, pipelines, and consumption layers, and will collaborate closely with product management and data science teams. The ideal candidate will have deep

Lead Implementation Consultant is a post-sales position that focuses on individual clients and implementing Cotiviti solutions purchased by that client. 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 a Cotiviti solution based upon a client’s specific needs. The Implementation Consultant will be the primary Client Services technical resource and will interface with the client’s technical resources. Duties can range from delivery of product training to new client specific...

The GTM Operations Technical Project Manager & Business Analyst is a multi-faceted role spanning across data management, project management, process improvement, and deal audits.  This role will collaborate across teams to provide analysis, propose changes, develop processes, project manage, and positively impact the GTM organization as a whole. This role is responsible for leading and managing projects from initiation to completion, ensuring that project goals are met on time and within budget. This role involves coordinating with cross-functional teams, managing resources, and maintaining effective communication with stakeholders.

The Director of Engineering AI will drive our AI Platform design across all lines of business. The Director will be responsible for the development and execution of the AI platform and machine learning applications that will empower Cotiviti's Product Groups to deliver innovative AI-powered experiences to our customers.

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 Senior Marketing Operations Manager to drive the execution, optimization, and innovation of our marketing operations and demand generation programs. In this role, you will develop and execute high-impact, integrated B2B demand generation campaigns that support revenue and pipeline goals. Partnering closely across the Marketing and GTM teams, you’ll act at both the strategic and tactical levels to conceptualize, build, track, execute, and optimize campaigns based on performance metrics.  

The Cotiviti Retail division are seeking a Senior Insights Analyst to work closely with our Retail operations and R&D teams. In this role, the analyst will design and develop reports and dashboards, provide analysis of complex data sets and provide actionable insights and strategic recommendations that drive business growth and optimize performance. This is a key role in guiding the data analysis process and collaborating with stakeholders to identify opportunities and implement data-driven solutions. This position would act as a subject matter expert to the team. We are looking for a...

We are seeking a Principal Interoperability Engineer with deep expertise in FHIR and Clinical Quality Language (CQL), combined with strong software engineering skills in .NET. The ideal candidate will design, implement, and optimize advanced healthcare interoperability solutions, translating complex clinical and quality measure logic into efficient, maintainable, high-performance code. This role requires both strategic technical leadership in interoperability standards and hands-on software engineering excellence. You will work closely with product managers, architects, and engineering teams to ensure compliance with healthcare regulations, data privacy requirements, and...

A Sales support, selling and development role dedicated to supporting Sales VPs in the sale of our PQR products.  This role requires product expertise in Quality Intelligence.    Candidate should have at least two years of experience with inside sales, sales development or a similar customer-facing role within the healthcare industry. ...

We are a Healthcare Data Analytics company looking for the Sr Manger of Engineering. In this role you will lead, direct, and manage the day-to-day operations of a software engineers and TPO’s. You will work closely with the enterprise data management teams, IT, engineering, Client Services teams, and Clinical operations teams. You will manage all the operational aspects of the software development to ensure business and project objectives are met and delivered on time. You will provide administrative, technical, and people leadership for multiple, diverse, and geographically distributed teams. You are responsible for providing feedback to the team and individuals on their performance.

Cotiviti is seeking a Sr Director of Product Marketing to join our Edifecs Product Marketing Team. The Sr Product Marketing Director will play a critical role in several areas of product marketing, including annual and strategic planning, market and competitive research and analysis, product positioning and messaging, sales enablement, including content creation and client presentation support, campaign development and execution, marketing project management, and event support. This associate will be collaborative, strategic, and have the ability to own and

We are seeking a motivated Senior AI Engineer to contribute to the design and development of our agentic framework and centralized AI platform. This role will focus on implementing and integrating AI agents, experimenting with open-source AI tools, and supporting the delivery of customer-facing and internal AI-powered applications. You will work closely with senior AI engineers, backend developers, and product engineers to bring agentic solutions to life, gaining hands-on experience with cutting-edge AI frameworks and infrastructure.

We are seeking a highly experienced Principal Software Engineer to design and build the backend infrastructure for our centralized AI platform. This role will focus on developing robust, scalable backend services that power our agentic framework and enable teams across the company to securely deploy, manage, and access AI agents through unified APIs and user interfaces.

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...

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. The ideal candidate will leverage their operational knowledge and subject matter expertise on processing data through various systems, recognizing revenue and audit regulations, and technical expertise in all areas related to Payer Gateway solutions (EDI, FHIR, API)...

We are seeking an experienced Manager, Engineering to lead our team. 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.

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...

The Client Services Manager is responsible for leading the cross-functional client team and providing the highest level of service to our clients. The role serves as both internal and external client liaison, including triaging, managing, monitoring, and support of a client-related activity, primarily related to Cotiviti Prospective Claims Accuracy products.

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.

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 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 Senior Application Security Engineer is responsible for ensuring the security of the organization’s business applications including business logic testing, code scanning and web application firewall. The individual will work closely with application development and production support teams to coordinate risk assessment, vulnerability analysis and remediation for business. This individual will also need to educate and assist application teams to adopt secure development best practices. The Senior Application Security Engineer will help define and drive the implementation of these capabilities and work to integrate application security processes within the SDLC and CI/CD processes.

The Sr 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 Sr 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 Sr Program Manager, Operations will leverage their deep healthcare and project management knowledge to deliver the highest quality of services to Cotiviti clients.

We are looking for a Software Development Manager to join our team. This role is responsible for designing a strategic perspective regarding IT architecture and business needs. You will also develop and implement architecture software strategy. Our ideal candidate with have strong software development experience working in an agile environment.

The primary focus of a Systems Engineer within IT Operations is to participate in projects that support technology growth and innovation. Systems Engineers also provide advanced technical support for all IT systems including server platforms, storage, and other cross-functional capabilities. They develop and implement new solutions, improve existing solutions, and provide a path of escalation for complex or high-risk IT requests.