Cotiviti is a leading solutions and analytics company that leverages financial datasets to deliver deep insight into the performance of retail system. These insights uncover new opportunities for retail organizations to collaborate to improve their financial performance and accuracy along with reducing inefficiencies.   The Principal Software Engineer is primarily responsible for the design, development and support of the existing software applications and...

Cotiviti is looking for an FP&A Analyst to join our Finance team. This person will support the Executive reporting of the organization, the budgeting/forecasting for one or multiple business departments for the corporation, and general ad hoc analyses/QA for external stakeholders.

The Senior Manager, Employee Relations, will play a critical role in developing and maintaining a positive work environment by managing employee relations programs and procedures. This role is responsible for conducting and overseeing investigations, conflict resolution, and ensuring compliance with labor laws and regulations. The ideal candidate will have extensive experience in employee relations, excellent judgment, and highly developed analytical, interpersonal, and communication skills.   The Senior Manager, Employee...

The Senior Manager, HR Business Partner, will be a member of a business unit and or functional leadership team and serve as a key business partner to provide strategic and tactical human resources leadership. This role will partner with other HR team members, such as talent acquisition, employee experience, operations, and total rewards. This role is responsible for driving HR initiatives that align with business objectives, enhance organizational performance, and foster a positive work environment. The Senior Manager, HRBP acts as a consultant on...

Cotiviti is looking for an industry leading Senior Data Scientist 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 reduce the cost of healthcare and improve health quality and outcomes.  Cotiviti’s Artificial Intelligence Group consists of data scientists, engineers and data analysts dedicated to developing and implementing robust, scalable, value-based...

The Senior Software Engineer specializing in Appian plays a pivotal role in steering the design, implementation, and optimization of low-code workflow and automation solutions across the enterprise. This role blends deep technical expertise in Appian with strong application architecture and workflow design capabilities.   This resource will immediately support our Payment BU workflow intelligence and optimization Initiative using Appian, collaborating with Cotiviti teams on Client Inquiry and Payment workflow use cases. Closely working with other architects and senior engineers, this individual will help assess existing applications,...

As a Medical Reviewer, you will be auditing medical records to evaluate the accuracy of medical coding and health plan policies for our Fraud, Waste & Abuse clients.     

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 Yield Support team works to facilitate daily administrative activities efficiently and professionally within the department and business unit by assisting our Data Mining (DM) and Coordination of Benefits (COB) Specialists, Recovery Operations, Revenue Cycle, and Inventory Management Specialists teams, to achieve success as an overall organization. This team will also work with the greater leadership team to improve and manage our business optimizations as well as meet and exceed our goals and deliver exceptional customer expectations both internally and externally.   As a Yield Support Specialist this role is under direct supervision...

We are looking for a Revenue Cycle Specialist to join our Yield Management team! This role is responsible for the reconciliation and posting of all payments received, identify discrepancies and analyze issues to ensure all payments are posted timely. Other responsibilities include managing inventory and system alignment between Cotiviti and our clients, reconciling data between different sources, research, and the ability to work with cross-functional teams.

Cotiviti recognizes data as a strategic business asset and a mission-critical resource and is committed to handling both its data and its client’s data responsibly. Information Governance (IG) is a Legal Department function that is responsible for the governance and oversight of risks related to information management activities, including data retention.   The Senior Manager, Information Governance (“IG SR. Manager”) is responsible for working directly with Cotiviti’s Senior Director, Information Governance (the “IG Director”) to support the implementation, enhancement, and...

The Technical Specialist will collaborate closely with the Payment Integrity - Content & Enablement Department, the Implementations Team, and the Audit Operations and R&D teams. This role involves the initial reception and generation of Business Rules, which are crucial for the functioning of RCA’s new platform applications. The Technical Specialist will be tasked with creating the logic for these business rules, ensuring their deployment for operational use, and maintaining comprehensive documentation and impact analysis for each rule. Additionally, the Specialist will act as a key liaison between the operations team and our Center of Excellence, facilitating effective communication and...

The Senior Support Analyst will assist in monitoring, analyzing and resolving data platforms, configuration, and infrastructure related issues. This person serves as a liaison between technical and operation teams. This position provides analysis and problem solving, technical assistance and support coordination to business stakeholders. The person will make decisions based on independent judgement to resolve a range of complete technical problems. The Senior Support Analyst needs strong analytical skills and the...

Perform Dental daily review/audits on client data for completeness and accuracy of coding, utilizing coding background to ensure appropriateness for reimbursement when providing recommendations on clinical claims to the client: Makes certain the requirements for Current Dental Terminology (CDT), ADA and other related concessions are met. Performs duties according to structured algorithms or other written guidelines. Handles moderately complex issues, refers all medical necessity procedures to higher-level staff for approval or denial. Possesses solid working knowledge of subject matter.  

The CSR Program Manager will play a crucial role in helping to manage the company’s CSR initiatives. This role will work in a dynamic and collaborative environment, where they will interact with various departments across the organization and external stakeholders.   They will be responsible for helping to manage and execute on the company's corporate social responsibility initiatives around Cotiviti Cares, including program design and execution, internal and external engagement, and impact...

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 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.

Cotiviti has multiple openings for full-time coders....these roles will focus on claims audits for appeals, checking for completeness & accuracy based on coding guidelines. Experience with E&M coding & auditing is preferred. These are full-time remote positions and can be done anywhere within the continental US and will work a traditional day time schedule.  

The Director of Solution Innovation Development will lead early research and development of new solutions for healthcare technology. The Director will hire, train, and lead a cross-functional team of BizOps, DataOps, AIOps, DevSecOps, & CloudOps engineers, and must be able to lead traditional full-stack solution development as well as AI development, and experimental vibe-coding and virtual agentic teams. The director will be tasked with building virtual

The Director, Implementation 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, in addition to managing a team of Implementation staff who will be guiding the delivery of services and technology to their own set of clients within defined book of business.

The Sr. Technical Product Owner (STPO) is responsible for driving solution definitions that support business ideas and product concepts at a team, program, and enterprise level through gathering and translating testable requirements into application software solutions. The STPO has deep domain knowledge, and strong experience in collaborating with a diverse team including product managers, software developers, testers, and teams such as Client Services, Operations, Clinical, Data Science, and Marketing. STPO has the ability to quickly learn and develop new products and support integration efforts across multiple products and release trains.

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.

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.

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.   

The Immigration Counsel will serve as in-house immigration legal advisor to Cotiviti. They will be responsible for partnering with leadership on company immigration operations in compliance with federal and state laws and administrative policies. This person will act as the extensive knowledge on all immigration related activities including, but not limited to, visa caseloads, immigration law, immigration document retention, communications with employees, etc. The Immigration Counsel will draft key documents, assist in the completion and filing of all immigration related paperwork, present clear recommendations, and assure legal compliance. They will handle the preparation of immigration...

At Cotiviti, we are custodians of clinical data for our clients, which requires effective data connectivity and security. The Interoperability Solutions Architect function uses a standards-based methodology to create connections between Cotiviti and clinical data sources such as electronic medical records, health information exchanges, national networks, and vendor partners. The Interoperability Solutions Architect will be responsible for data connectivity and ingestion. In this role, you will facilitate discussions...

A Revenue Cycle Specialist 2 is a member of the Revenue Cycle team within the Yield Management Division. The Specialist 2 is responsible for moderate to complex levels of recurring and/or daily functions and processes that are necessary for business execution. This would include the reconciliation and posting of all payments received, identification of discrepancies, and analyzed issues to ensure payments are posted timely. Other responsibilities will include processing invoices, managing large sets of inventories and the ability to process electronic requests in multiple systems and platforms.  

The Team Lead is a member of the Revenue Cycle team within the Yield Management area of Cotiviti. This department will work directly with other members of Yield to ensure department expectations are accomplished.   This role is responsible for training, leading and daily oversight of Revenue Cycle Specialists, Specialist 2 and Seniors, as well as the knowledge share and refinement of Revenue Cycle

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 Senior Project Manager is tasked with driving large, cross-discipline, company-wide projects with high executive visibility. These projects include post-merger integrations, international operations, systems implementations, and other projects as directed. As each project is different, the project manager must use a variety of tools, approaches, and formal methodologies to successfully complete the objectives. This position is strongly self-driven, with the project manager given an end goal and responsible for independently driving the project to success, while interacting with a large variety of independent teams and separate disciplines. Projects can involve simultaneous coordination...

The Senior Technical Specialist from Coordination of Benefits (COB) 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 requirements consistent with SAFe (Scaled Agile Framework). You will also handle tracking of project 

Manager of Clinical Content is a key member of the Content Center of Excellence, responsible for managing a team of nurses, medical coders and analysts that create and maintain policies in the Cotiviti payment policy library. This position works collaboratively with the global and onshore Medicaid teams as well as other payment policy teams (e.g., configuration, eLL, client team). The manager role is a hands-on position working diligently with team members to meet goals and deadlines. This includes an active role in the policy development process by interpreting company and regulatory guidelines, performing quality audits, and claims data analysis at multiple levels. The manager is similarly involved in post policy implementation...

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 PPM polices and rules. This is a full-time role and can work remotely in the US. 

The ideal candidate for the Senior Technical Product Owner (TPO) acts as a crucial link between product management, stakeholders, and agile development teams, ensuring that the technical implementation of a product aligns with the overall business vision and strategy. They are responsible for guiding product development, managing technical aspects, and ensuring product features meet both user needs and technical feasibility requirements. A 

The Attorney, Vendor will 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 significant experience negotiating a wide range of commercial agreements – particularly in the areas of technology (SaaS agreements/software...

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.

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

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.

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.   

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.   

At Cotiviti, the Director of Data Architecture and Management – AI will lead the Data Architecture and the Product teams within the AI team. This individual will be responsible for leading and establishing process, engineering patterns, product vision, standards and governance around all data assets within the AI Data platform.

The Stars Analyst works across the Cotiviti clientele to define, assign, and oversee best-in-class activities and Stars performance for all assigned Medicare Advantage plans. This individual is accountable for driving greater value and success for our customers by focusing on data, next best actions and maximizing member and provider outreach. They will also support identification of enhancements or improvements in the Cotiviti solutions to better support our clients.   The Stars Analyst will directly own and manage a small number of clients and is responsible to oversee all...

This Coding Validation Analyst I position will perform daily audits on client data for completeness and accuracy of coding utilizing both coding and clinical knowledge and background to ensure appropriateness for reimbursement and will also respond to provider appeals. This position requires strong organizational skills and the ability to meet strict key performance indicators in a fast-paced work environment. Daily, substantive contact with internal staff.    This is a closely monitored productivity-driven role and can be done anywhere in the continental US (this is shift work and hours need to be flexible...this team runs 24 x 7)....

The Application Architect (App Arch) (Enterprise) implements and governs technical architecture development and provides architectural leadership and guidance to align IT solutions and development organization with the needs of the Enterprise. Will span multiple architecture domains (e.g., Application/solution architecture, Technical/Infrastructure architecture, Information/Data Architecture & Business Architecture) to ensure balanced solutions.  This App Architect role is specific to the IAM (Identity and Access Management) technology area, specifically OKTA, from a development perspective.  The Role will provide standards on Development interfaces using Industry Standards approaches such...

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 Sr 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 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...

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,...

The Subrogation Recovery Specialist is responsible for analyzing and recovering dollars related to an accident, injury, or illness in which another party is responsible. The Subrogation Recovery Specialist must work with attorneys, other health carriers, adjustors and more to both accelerate and maximize settlement amounts which will lead to savings for our clients. This position requires a combination of both oral and written communication skills combined with the ability to proficiently review healthcare claims and case documentation to deliver value and maintain a high standard of quality.

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...

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.