Cotiviti is looking for a senior pricing analyst to join our Finance team. This individual will oversee pricing for all business units and products. This includes support of the evolution and improvement of the price book and pricing process, coordinating price quotes for new opportunities, and helping secure favorable outcomes for key client renewals. This role will partner with leaders across Cotiviti to drive financial growth while ensuring contracts are market competitive and meet profitability expectations. This is a highly visible role that is critical to Cotiviti’s overall growth strategy.

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 Client Service Analyst (CSA) role ensures adequate support for the client-facing team on coding and policy as well as operational related activities. The CSA must be familiar with the day-to-day activities of the Client Policy Manager (CPM), Client Service Manager (CSM) and client-facing Medical Directors.

The Technical Project Manager will be responsible for leading/organizing the projects as well as assisting teams as like scrum master to oversee and guide scrum teams. They will partner with various other teams at Cotiviti, including Research & Development and Operations to deliver client centric projects. Technical Project Manager will also contribute to continuous improvement of work management processes to ensure the most efficient delivery of Scrum Teams. To be successful as a Technical Project Manager, you should have a firm grasp of agile practices and the ability to effectively manage and mentor development teams. An outstanding Tech Project Manager should have excellent...

We are seeking a passionate and experienced Customer Program Manager to join our team and drive long-term success for our customers through strategic engagement and operational excellence. In this role, you will serve as a trusted advisor and relationship manager, aligning Cotiviti’s software and services with customer goals to deliver measurable outcomes. You will lead initiatives that enhance customer satisfaction, resolve issues, and support program growth, while collaborating cross-functionally with Account Management, Product, and other internal teams.

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 Director of Implementations will guide the delivery of services and technology to one or more clients by planning and managing implementation activities from point of sale through production verification.

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.

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...

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 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.

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.

Cotiviti is seeking a passionate and results-driven Technical Customer Solutions Manager to join our team and play a key role in driving long-term success for our clients through the effective use of Cotiviti products. In this strategic role, you will act as a trusted advisor to our healthcare payer clients, leveraging your deep operational knowledge of data processing systems, regulatory compliance, and enterprise system integration. Your expertise will help clients maximize the value of their Cotiviti investment while expanding our impact across the healthcare payer landscape. The ideal candidate combines strong technical acumen with a deep understanding of healthcare EDI operations, encounter data...

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...

We are seeking a highly skilled and experienced developer to join our dynamic team. The developer will be responsible for designing, developing, and maintaining software applications using various programming languages and technologies. The ideal candidate must have a strong background in Power Apps, Power Automate, AI Builder, and Azure AI Studio, as well as proficiency in languages such as Python, C# sharp, .NET, Blazor, JSON, etc.

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 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 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.

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 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.

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 Intern - Technology Research Assistant/Analyst is responsible for researching technologies and use cases for Cotiviti solutions. This internship role will report to the Director of Platform Strategy & Innovation and work on Portfolio Prospecting within the Innovation & Portfolio Management Center of Excellence (IPM). IPM Portfolio Prospecting reduces investment risk and improves speed to value through early exploratory validation, development, and delivery of solutions. Portfolio Prospecting is tasked with maintaining transparency into the strategic environment and positioning Cotiviti with validated long-term pathways to competitive advantage.

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,...

Cotiviti, Inc. (formerly Verscend Technologies) drives better healthcare outcomes through data analytics. This means taking in billions of clinical and financial data points, analyzing them, and then helping our clients discover ways they can improve efficiency and quality. Learn more at www.Cotiviti.com.

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 

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.

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,...

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 Generative AI Developer Intern focuses on researching and developing advanced healthcare informatics, particularly in the realm of Generative AI and emerging Artificial General Intelligence. It is designed to support improvements in healthcare treatment, payment, and operations. The intern will assist and take a primary role in developing, researching, creating analytical materials, and collaborating with various teams to drive AI-related projects.   We are currently looking for interns who can start in...

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...

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.

The Generative AI Research Engineer Intern conducts primary and secondary research of advanced and emerging healthcare informatics technology with a focus on Generative AI and emerging Artificial General Intelligence technology for healthcare treatment, payment, and operations use cases. Creates research papers, analytical reports, proposals, and educational material. Maintains a deep understanding of technology trends and hands-on experience with relevant technologies. Develops generative AI models, architectures, databases, and systems to improve healthcare solutions.   We are currently looking for interns...

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.

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 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. 

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...