The Coordination of Benefits (COB) & Data Mining (DM) Audit Support is a member of the greater Coordination of Benefits and Data Mining Business Units (BUs.) 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.

We are seeking a seasoned consultant with over 10 years of experience in OFCCP audit preparation, specifically across multiple establishments, including CMCE audits. The ideal candidate will educate our team on the audit process (supplemented by our relationship with our AAP vendor), review submissions, and prepare us for interviews. Your expertise will be invaluable in ensuring our compliance and readiness for a successful audit outcome.

The Senior Software Engineer - Full Stackwill work with core applications and database in the Payment Policy Management platform to help build and deliver features as a part of the team using SAFe practices. The developer will need to have strong healthcare background and be familiar with the domain. The developer will be focusing on one or more specific initiatives with the team. The developer will be responsible for implementing features for upcoming new initiatives while also making recommendations and improving the existing code base.   The developer...

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 Senior Software Developer will work with core applications and database in the Payment Policy Management platform to help build and deliver features as a part of the team using SAFe practices. The...

We are looking for an Recovery Resolution Specialist 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.

As a member of the Recovery Workforce Team within Yield Management, this workforce operates as an internal consulting team in collaboration with our greater Recovery Operations segment to assist with identifying and addressing departmental gaps, solutions for driving results and analyzes overall workflow management within existing policies. This department will play a key part in the review and implementation of new client prospects for Recovery Resolution/Quality as well as define and drive strategic, operational, and organizational improvements across the greater Recovery Operations space. As a Recovery Workforce Specialist, this role, will require an intellectual curiousness, quick adaptability,...

The Senior Retail Auditor position is responsible for developing new and existing audit concepts, gaining client acceptance, training all audit levels to execute audit projects and evaluating the effectiveness of audit concepts with the goal of auditing client data generating high quality recoverable claims for the benefit of Cotiviti and our clients.

We're looking for an Auditor 1 to join our Retail audit team. Cotiviti Retail audits purchases and payments related to merchandise inventories. We develop and prioritize an audit program to ensure value negotiated is value delivered, recommending actionable process improvements that help our clients improve the way they do business and mitigate financial loss from overpayments and under-deductions.   This job can be US-remote or Canada (Ontario area remote).

Our retail recovery auditors are passionate about what they do. They are experts at reviewing, discovering, and validating large amounts of data and delivering results and insights for our clients. Our audit teams recover billions of dollars in incorrect payments for our clients each year. The Auditor position is a key, entry-level role where you will learn from an elite team of recovery professionals, expand your skills, discover your strengths, and begin an exciting career. This is an entry-level role that can work remote from home in the US or Ontario Canada and would be a great fit for a recent college graduate (finance, accounting, etc.).    

The DevOps Engineer primary responsibility is driving cloud automation, best practices and enhancements on our Cloud Platform Engineering team. The mission is to support teams by providing infrastructure, resources, and tools that allow them to automate, develop, self-service and experiment.

The 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...

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 Product Owner drives solution definitions that support business ideas and product concepts at a team and program level by gathering and translating testable requirements into application software solutions. The Technical Product Owner has deep domain knowledge and strong experience collaborating with a diverse team, including product managers, technical architects, software developers, testers, and teams such as Client Services, Operations, Clinical, Data Science, and Marketing. This is a combined Role of TPO and SM (Scrum Master).

  This clinical analyst 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. The formal title for this role is Coding Validation Analyst I but is staffed with RN's.   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). Shifts include (after training): second and third shifts (in Mountain Time) with...

The purpose of the BI Developer role is to design, develop, and implement business intelligence solutions that empower our organization to make data-driven decisions. The BI Developer will be responsible for creating and managing data-driven solutions that provide actionable insights, improve operational efficiency, and drive strategic decision-making. This role is critical in helping the organization leverage data to gain a competitive advantage and achieve business objectives.

The Data & Insight Analyst is responsible for architecting and developing best-in-class and innovative analytics and reporting solutions.  This role will have responsibility for establishing, running, and sustaining processes and practices that support Big Data, Analytics, and Reporting solutions and applications in an Open Source environment. The Data & Insight Analyst should have a passion for data, working with business people, and creating solutions and driving value with a keen interest in mentoring and elevating other technical resources.  This role will spend time working independently and as part of a team and will focus on...

As a Business Development Manager (“BDM”), you will lead the Business Development team, support the growth of the sales pipeline, and expand target account intelligence for Cotiviti.  The Business Development Team frequently is the voice of Cotiviti, which sets the tone of the customer experience, particularly in first-contact situations.  You will work closely with the Sales team and Sales Leadership to support the management of sales territories by establishing relationships, conducting introductory conversations, and gathering intelligence that enables Cotiviti to favorably compete for the prospects’ business.  The BDM will support analysis and reporting needs by developing business profiles...

We are in search of a DevOps Engineer with a specialization in Azure AI Studio, Azure Open AI, Microsoft Copilots, AI and ML methodologies, and AWS Bedrock. In this role, you will be the guiding force behind our AI initiatives, providing expertise and leadership to all users across the organization who have AI use cases. Your focus will be on architecting, developing, and implementing advanced AI solutions while ensuring alignment with best practices and business objectives.

We are 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 contributing to improving our retail clients’ profitability and want to be part of a team that provides opportunities for career growth. If you want to make a difference and contribute to the service we provide our Retail clients, consider an opportunity to join our global retail recovery team as an Auditor II.   The critical function of a Contract Compliance Auditor II is to audit billings...

The Data Integrator / BI Developer will be responsible for end to end configuration management for Internal Benchmarking releases.  This position will be responsible for data modeling/transformation/integration as well as business intelligence visualization design/development.  Position also acts as senior level consultant for both Data Engineers and BI Developers.  Internal Benchmarking BI Developer will also be primary lead for (new) solution functionality/POCs for team. 

An AI Security Architect is responsible for designing and implementing robust security frameworks for AI systems, ensuring their protection against adversarial attacks, data breaches, and ethical issues. This role involves developing secure deployment strategies for AI models, particularly focusing on generative AI's unique risks, such as content generation and privacy concerns. They work closely with data scientists and engineers to integrate security measures throughout the AI lifecycle, from development to deployment. Additionally, the AI Security Architect ensures compliance with regulatory standards and promotes ethical AI use, maintaining the integrity and trustworthiness of AI solutions.

The Information Security - AI Governance and Risk will lead the development and implementation of governance frameworks for AI systems while overseeing risk management strategies related to information security. This role is pivotal in aligning AI technologies with organizational security policies, regulatory requirements, and ethical standards. The ideal candidate will work closely with cybersecurity teams, data scientists, and compliance officers to ensure secure and responsible AI deployment.

The Sr BI Administrator will be responsible for working in the Cotiviti Infrastructure team. We are in search of a proficient Senior Power BI/ Microsoft Fabric Engineer/Developer with expertise not only in developing insightful dashboards and reports but also in administering Power BI and Microsoft Fabric environments. In this role, you will play a pivotal part in managing the technical and security aspects of these environments while ensuring optimal utilization. You will provide guidance on best practices for utilizing these tools, facilitate user training sessions, and oversee integrations with other systems.

Cotiviti is seeking an Implementation Services Analyst.  The role will be 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 project management software and reporting mechanisms. ...

We are eagerly looking for several motivated administrative professionals for our Retail Audit team in our new Mexico City office. In this role, you will efficiently and professionally handle the daily administrative activities within the department, to assist our retail auditor(s), collectors, managers, Business Optimization and others to meet and exceed customer expectations. You will act as a point of contact for the audit team in facilitating responses to general inquiries and data requests from both internal and external customers. This role is an excellent way to "get your foot in the door" and learn the business so that you can grow with the company as we expand.  Must be...

We are looking for a Software Development Manager to join our team. This role is responsible for helping build the delivery roadmap and executing on it. You will also develop and implement the technical roadmap. You will be responsible for a team of developers and QA and will guide and support them with delivery. Our ideal candidate with have strong software architecture and development experience working in an agile environment. Also, with a desire and ability to be hands-on with day to day development and architecture activities.

The Data Scientist I - Generative AI  is focused on machine learning solutions in Healthcare Technology and builds value-oriented, production level machine learning solutions. This is not a research oriented data scientist; instead you will apply your 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.  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...

As a Clinical Program Manager in our growing member engagement line of business, you will be at the forefront of improving patient outcomes by developing impactful outreach and health awareness programs implemented through Cotiviti’s leading Quality and Eliza Member Engagement solutions. Your role will center around engaging health plan members by designing best-practice based outreach campaign programs, closing care gaps based on HEDIS and Star quality measures, and working with our extensive list of health plan clients to drive value to their proactive member 

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.

The Intern Technology Solutions 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. Preferred location is...

The Senior Database Developer - Oracle is primarily responsible for the performance and stability of critical applications. You will be expected to implement changes, bug fixes that support onboarding of new clients and quick resolution of production issues.  You are expected to foster high performing technical teams.  You will be required to collaborate effectively with senior developers, offshore development team members, business owners, project management, and other internal stakeholders.

This is an onsite position at our Blue Bell, PA office.   In the End User Computing Analyst role, you will provide support for internal employees for all IT services. You will also process incoming technical support incidents and requests through the ServiceNow & JIRA ticket queue while maintaining service level agreements.

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.

Our Healthcare Data Analytics company seeks AVP Engineering within our Payment Integrity business. In this role, you will lead, direct, and manage the cross-functional technology delivery team. You will handle all the operational aspects of software development to deliver business and project objectives. In addition, you will provide technical, administrative, and people leadership for multiple, diverse, geographically distributed teams.

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 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 Cotiviti product suite. The successful candidate will be required to collaborate effectively with senior developers, offshore development team members,...

The Software Engineer is primarily responsible for the support and modernization of the existing proprietary designed IVR (automated cloud-native) software, and enhancement of other software components deployed in the Cotiviti product suite.

The focus of the VP, Client Engagement Manager is to develop and execute against growth, renewal and retention strategies for their customers within the top customer tier. The VP Client Engagement Manager 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 role will manage a team of Client Engagement professionals.

We're looking for an Auditor 1 to join our Retail audit team. Cotiviti Retail audits purchases and payments related to merchandise inventories. We develop and prioritize an audit program to ensure value negotiated is value delivered, recommending actionable process improvements that help our clients improve the way they do business and mitigate financial loss from overpayments and under-deductions.   This job can be US-remote or Canada (Ontario area remote).

Cotiviti Retail audits purchases and payments related to merchandise inventories. We develop and prioritize an audit program to ensure value negotiated is value delivered, recommending actionable process improvements that help our clients improve the way they do business and mitigate financial loss from overpayments and under-deductions.    Too often, audits, contract reviews, and recovery efforts focus on one aspect of a retailer’s operations without considering how the business works as a whole. Cotiviti Retail works smarter and digs deeper, looking at a business from all angles to find sources of profit in unexpected places....

The Senior Retail Auditor position is responsible for developing new and existing audit concepts, gaining client acceptance, training all audit levels to execute audit projects and evaluating the effectiveness of audit concepts with the goal of auditing client data generating high quality recoverable claims for the benefit of Cotiviti and our clients.

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 Software Engineer is responsible for the design and development of software applications and reusable software components for the Cotiviti Inc product...

As a Senior Data Engineer, you will work with the team to build complex data pipelines using various data ingestion platforms as well as several new and exciting products in the Big Data/Advanced Analytics space. You will operate in a fast-paced environment where multiple project deliverables are coordinated within specified deadlines. The primary responsibility of this role is to deliver accurate and timely data across various products to enable revenue for the company. The ideal candidate would have data analysis and data pipeline development experience using big data tools (like Spark, Scala, Hive), relational databases, advanced SQL skills. Healthcare knowledge is a plus.

This is a hunter role in the healthcare payer space. Extensive experience calling on and selling to Health Plan “C” level executives, SVP Business Owners, procurement, VPs and directors is essential. Experience working in a leading Health Plan software and service vendor in the Payment, Analytics or Population Health industry is also key. We are looking for candidates across the US.

We are 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 contributing to improving our retail clients’ profitability and want to be part of a team that provides opportunities for career growth. If you want to make a difference and contribute to the service we provide our Retail clients, consider an opportunity to join our global retail recovery team as an Auditor II.   The critical function of a Contract Compliance Auditor II is to audit billings...

The Data Scientist I is focused on machine learning solutions in Healthcare Technology and builds value-oriented, production level machine learning solutions. This is not a research oriented data scientist; instead you will apply your 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.  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...

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 Cotiviti product suite. The successful candidate will be required to collaborate effectively with senior developers, offshore development team members,...

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. This position may be worked remotely from home anywhere in the US.  

The End User Computing Engineer works independently to build and integrate several robust, fault-tolerant application solutions for information processing requirements to maximize audit site productivity. This includes collaboration in requirements definition, prototyping, design, coding, testing and deployment.   We will consider full-time remote, work-from-home arrangements or onsite at our Mexico City office.