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 ideal candidate for the Business Intelligence (BI) Manager role will lead the Reporting and Data Visualization team to support the Risk Quality Consumer (RQC) business unit. This role involves managing the development and maintenance of BI solutions that enhance business performance and drive organizational growth. The incumbent will be responsible for the daily activities of a team of data analysts, managing the intake process, gathering requirements, estimating resources, prioritizing requests, and ensuring that deliverables are completed on time to meet or exceed the stakeholder's expectations. They will collaborate with various business partners to identify data needs, create...

We are a Healthcare Data Analytics company looking for a Manager Software Engineering. In this role you will lead, direct, and manage the day-to-day operations of software engineers. 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 looking to add a Dental Analyst to our team. As a Dental Analyst you will perform daily audits on client data for completeness and accuracy of coding utilizing coding background to ensure appropriateness for reimbursement.  The ideal candidate will have a background in dental coding/billing and have a comfort level on reviewing dental claims for completeness and alignment to coding & clinical guidelines. Having hands-on experience with dental procedures such as taking/reading x-rays, periodontal charting, assisting with dental procedures being performed is highly desired. This is a full-time position and can be done from home in the continental US.

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.

Cotiviti, Inc. 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.

As the DCO Director you will be responsible for the management, strategy, and execution of Datacenter infrastructure for Cotiviti. You will be overseeing technical projects in alignment with organizational goals and coaching direct reports within the organization. Directing the effective delivery of rack, space, cabling, power, capacity of the datacenters, and corporate offices IDF / MDF closets as well as processes.

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...

As an AI Program 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.

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.

  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. Daily, substantive contact with internal staff. 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): First,...

The Technical Product Owner is responsible for driving solution definitions that support business ideas and product concepts at a team and program level through gathering and translating testable requirements into application software solutions. The Technical Product Owner has deep Healthcare 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. The Technical Product Owner also has experience working with Web Services and RDBMS Databases.

Conducts and leads 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. Conducts executive briefings, consultations, educational sessions, and formal training for select strategic technologies. Supports technology and innovation strategy efforts in partnership with Business Unit technology leaders. Maintains a deep understanding of technology trends and hands-on experience with relevant technologies. Supports research and...

The QA I, Clinical Ops position works with the Coding & Clinical Validation Audit team focused on risk coding. The QA position monitors & reports on the accuracy of all code captures on a % of all images of their assigned coders. This position also answers all questions for their coders through the Questions Queue or via email. QA is also responsible for assisting in the remediation for their coders which include full image review of all images coded prior to release to ensure accuracy of image, for any coder below project benchmark.

The Clinical Abstraction Lead will function as client/team support during the MRR (Medical Record Review) HEDIS® season and during off-season projects. The Clinical Abstraction Lead position will have responsibility for supervising a seasonal team of abstractors, over readers and QA staff. This oversight includes quality, productivity and follow-up training of their measure specific team. This role is to ensure that the work of assigned team members meets productivity standards, quality standards and client deadlines. Primary responsibilities include production queue management based on daily reporting, work distribution, team performance, and production optimization.  

The Power BI Developer collaborates with various team members and operational departments to develop internal and external reporting tools and gather/analyze requirements using industry best practices. They will work extensively in both ad-hoc and standard reporting packages and be involved in creating reports and dashboards that are scalable with large volumes of data.

The Vice President, Sales is responsible for the development and strategic execution of annual sales plans to support the acquisition of new clients and sale of new solutions for the Cotiviti Retail division. This is a hunter role focused on hunting new business for Cotiviti’s Retail Payment Integrity Services and Solutions to the world’s largest retailers, e-commerce, and commercial enterprises. Demonstrated experience calling on and selling to “C” level executives, SVP Business Owners, CFO’s, Procurement, VPs, and Directors is essential.  Experience working in a disruptive software and services sector selling Data Analytics, Payment Integrity / Recovery Auditing services and...

As a Senior Database Admin, you will help drive team(s) in meeting project objectives. You are expected to contribute to and foster high performing technical teams. You will also be responsible for the design and coding of complex DB systems. You will collaborate and communicate effectively with architects, engineers, QA, DBAs, and Business managers to solve complex problems spanning their respective areas and...

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.

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 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 innovation 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 specific deadlines in an Agile development process as defined by the...

Cotiviti is currently looking to add an industry leading Data Scientist II, 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 will work with a vast amount of structured and unstructured data, including claims, membership,...

This auditing role will focus on Coding & Clinical Chart Validation for our Inpatient audits. The ideal candidate for this position needs to have both a clinical (nurse) and a coding / auditing background focused on the following disciplines from a coding and billing perspective: Inpatient DRG/APR-DRG. This position is responsible for auditing inpatient claims and documenting the results of those audits, with a focus on clinical review, coding accuracy, and the appropriateness of treatment setting and services delivered.

The Medical Director focused on Implementation & Sales is a key member of the Go To Market team. The role is to serve as a coding and medical payment policy subject matter expert (SME). This position is responsible for supporting the sales process for our Payment Policy Management and Clinical Validation lines of business, reviewing and presenting results of the Opportunity Analysis supporting sales, and presenting policy/directing the client toward appropriate policy adoption during the implementation phase.  The Medical Director will then transition the client to a Client Medical Director after approximately 30 days post...

The Data Scientist II - 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 innovators to...

Strategic Vendor Solutions ("SVS") provides support services to the entire Cotiviti, Inc. ("Cotiviti") organization for the contracting of vendors who provide products and services to Cotiviti as well as any vendors with potential to join Cotiviti's mission through a joint venture, product development or some other form of strategic partnership.   Cotiviti is a leader in analytics driven healthcare payment accuracy and quality-based solutions with locations in the USA, Canada, Australia, Nepal and India and relies heavily on leading edge technology to deliver these products and services to our wide range of customers. SVS is tasked with...

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,...

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...

A Product Manager is a key role within an assigned business unit that is responsible for the development, strategy, and performance of a specific product or product line. Plays a critical role in driving the success of a product by defining its vision, strategy, and execution plan, and collaborating with cross-functional teams to bring it to life.   Successful Product Managers possess a combination of technical expertise, analytical acumen, communication skills, leadership abilities, customer focus, strategic thinking, and collaboration skills. They play a critical role in driving the success of a product and delivering...

The Senior Data Scientist will join a highly skilled data science team and work directly with a talented team of software engineers, auditors, product managers and customer experience managers to analyse healthcare data and deliver value for our clients.

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.