Cotiviti

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Job Locations US-Remote
ID 2024-13683
The Senior Manager of Clinical Services will be responsible for driving operational efficiency, product quality, clinical review optimization and alignment to meet client needs for HEDIS, STAR and other health measure chart review and abstraction related services. This role will closely partner with Program and Product Management teams to prioritize innovation and support our market and customer needs.   HEDIS® is a registered trademark of NCQA.
Category
Clinical Operations
Job Locations US-Remote
ID 2024-13670
The Support Engineer will assist in managing and coordinatingrecovery efforts for all events impacting production processes, SLA’s and client satisfaction. 
Category
Engineering/IT
Job Locations US-Remote
ID 2024-13667
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...
Category
Engineering/IT
Job Locations US-Remote
ID 2024-13645
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.
Category
Customer Service/Retrieval Operations
Job Locations US-Remote
ID 2024-13620
A Payment Accuracy, Coordination of Benefits (COB) Specialist 1, 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.   The Payment Accuracy, Coordination of Benefits (COB) Specialist 1 position is responsible for reviewing and analyzing the multi-client impact, complex member selection, and query or filter construction of data to identify instances of recoverable...
Category
Audit - Healthcare
Job Locations US-Remote
ID 2024-13619
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.
Category
Coding
Job Locations US-Remote
ID 2024-13613
In the role of Concept Development Analyst within our Clinical Chart Validation organization, you will lead in the identification, creation, and implementation of innovative concepts within the healthcare billing and coding field. Drawing from your industry experience and knowledge of clinical practices and regulations, you will assist in the development of novel strategies to enhance our claim selection processes. Your proficiency in data analysis, organizational skills, and understanding of claim selection methods in conjunction with extensive knowledge of Medicare and Commercial payer requirements associated with Inpatient, Outpatient, and Physician based healthcare payment systems...
Category
Audit - Healthcare
Job Locations US-Remote
ID 2024-13593
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.  
Category
Coding
Job Locations US-Remote
ID 2024-13591
The Coding Manager leads a team of coders, directly or indirectly, to deliver key components to the Cotiviti coding program. This role works with the Director of Coding, the Client team and other areas related to production, QA, and analytics for oversight of ongoing production and quality accuracy.
Category
Coding
Job Locations US-Remote
ID 2024-13587
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.
Category
Engineering/IT
Job Locations US-Remote
ID 2024-13584
The Policy Quality Auditor I role is responsible for ensuring the accuracy of new policies and current policies for existing healthcare clients. This role serves as the final checkpoint in validating the accuracy of developed and processed work orders created and configured for rules.
Category
Payment Policy Management
Job Locations US-PA-Blue Bell
ID 2024-13580
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.
Category
Engineering/IT
Job Locations US-Remote
ID 2024-13565
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...
Category
Sales
Job Locations US-Remote
ID 2024-13564
At Cotiviti, we are custodians of data for our clients, which requires efficient processes to manage data ingestion, data production, data quality and data security. The Data Analyst function provides insight into different aspects of the data operations, from raw data analysis to the quality of data in the deliverables. The Data Analyst will be responsible for data management and data quality. In this role, you will host and facilitate discussions with healthcare data carriers to manage data intake and ensure all client data requirements are discussed and...
Category
Audit - Healthcare
Job Locations MX-Mexico City
ID 2024-13548
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 suite, in compliance with predefined coding standards and technical design. This person will collaborate effectively...
Category
Engineering/IT
Job Locations US-Remote
ID 2024-13530
Data Integ Spec Anlytc IT is considered a senior team member that develops, enhances, and provides insight for data integration and serves as a subject matter expert for healthcare claims analysis. This role also provides consultative in-depth evaluation and analytical support to internal and external customers on various projects and conducts detailed claims analysis, assists in model development, assists in statistical analysis, and ad-hoc reporting as prioritized by management. The position communicates the outcomes of analysis to business owners,...
Category
Reporting and Analytics
Job Locations US-Remote
ID 2024-13519
The Product Manager (within Payment Accuracy Product Suite) will be responsible for product management and development supporting product growth.  This role will enhance and extend the Cotiviti product roadmap for our clients.  This role will serve as product subject matter expert working closely with stakeholders for product requirements, design and delivery.  Initially focused on our Dental product line, will grow into other areas.
Category
Product Management
Job Locations US-Remote
ID 2024-13517
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...
Category
Reporting and Analytics
Job Locations US-Remote
ID 2024-13515
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.
Category
Fraud, Waste, & Abuse
Job Locations US-Remote
ID 2024-13479
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...
Category
Engineering/IT
Job Locations US-Remote
ID 2024-13475
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).
Category
Engineering/IT
Job Locations US-Remote
ID 2024-13464
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.
Category
Sales
Job Locations US-Remote
ID 2024-13452
The Policy Design Specialist role is responsible for managing health plan clients and executing monthly project requests. Perform policy configuration maintenance of current medical policies along with implementing new health plan medical policies per client request. Adhere to and remain in alignment with the most up to date healthcare industry medical coding guidelines. Perform data analysis to determine how to accurately apply coding updates and client requested customizations. Execute quality assurance checks to ensure appropriate claim editing recommendations are applied based on client request.
Category
Payment Policy Management
Job Locations US-Remote
ID 2024-13451
The Product Manager will analyze market opportunities and define needs for analytics solutions across the Cotiviti enterprise, with a focus on Artificial Intelligence (AI). They will support a matrixed, shared service performing value and business case analysis for Enterprise Product and Business Unit Product teams. They will provide the business and product perspective and requirements to engineering and other departments within Cotiviti. This includes defining the problem to solve, quantifying the business value of a solution, and determining measures of success, along with communicating product workflows that enable ease-of-use for end users and documenting specific features and functions to improve and expand Cotiviti's analytics...
Category
Product Management
Job Locations US-Remote
ID 2024-13448
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...
Category
Reporting and Analytics
Job Locations US-Remote
ID 2024-13447
Working in an agile software development environment, the Sr DevOps / CI-CD Automation Engineer is responsible for automating build-test-deploy lifecycle for wide variety of applications/services in the cloud. As part of the Advanced Solutions Group team, you will focus on enhancing platform services and contributing code to multiple automation projects. You will also utilize engineering and programming skills focused on enabling a DevOps model, participating with Architecture, Operations and Engineering teams within Agile processes. The role will include systems and solution design within the existing architecture, as well as design/implementation of improvements to meet business needs. The Senior DevOps engineer will work...
Category
Engineering/IT
Job Locations US-Remote
ID 2024-13441
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,...
Category
Engineering/IT
Job Locations US-Remote
ID 2024-13440
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...
Category
Engineering/IT
Job Locations US-Remote
ID 2024-13432
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.
Category
Audit - Healthcare
Job Locations US-Remote
ID 2024-13428
Cotiviti is currently looking to add an industry leading Data & Insight Analyst who is focused on architecting and developing best-in-class and innovative analytics, reporting, and support our AI/ML Center of Excellences. This role will have responsibility for establishing and sustaining processes and practices that support Big Data, Analytics, and Reporting solutions and applications. The Data & Insight Analyst should have a passion for data, working with business people, creating solutions, and developing causal relationships that fuel a data-driven culture. This role will involve working independently and as part of a team and will focus on specific deadlines in an...
Category
Reporting and Analytics
Job Locations US-Remote
ID 2024-13426
Cotiviti is currently looking to add an industry leading Data Scientist I - ML, 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,...
Category
Engineering/IT
Job Locations US-Remote
ID 2024-13388
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...
Category
Sales
Job Locations US-Remote
ID 2024-13325
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...
Category
Engineering/IT
Job Locations US-Remote
ID 2024-13313
The Consumer Tech Writer will lead the development and maintenance of both external and internal facing documentation for Cotiviti’s Consumer Engagement platform, Eliza. Documentation includes user guides, release notes, printed manuals, help files, and other media as needed by the organization.
Category
Client Services
Job Locations US-Remote
ID 2024-13295
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.   We are currently looking for multiple Remote Risk Adjustment / HCC Coders for full-time...
Category
Coding
Job Locations MX-Mexico City
ID 2024-13275
We are seeking a highly motivated and detail-oriented Associate Data Scientist to join our innovative team. This entry-level role is ideal for recent graduates or individuals with limited experience in data science but with a strong passion for data and a keen interest in the healthcare industry. The Associate Data Scientist will work under the guidance of senior team members to support the development and deployment of data-driven solutions. If you are passionate about data and eager to solve complex problems, we encourage you to apply.
Category
Reporting and Analytics
Job Locations US-Remote
ID 2024-13259
The Client Retention Director is a role within the Go-To-Market team dedicated to partnering with Cotiviti’s internal Sales, Client Engagement, and the /business unit to successfully renew strategic or named clients with favorable terms and conditions. The Client Retention Director is responsible for independently leading assigned deals and working as a member of a collaborative team. The role will be responsible for proactive management of the renewal schedule for assigned clients working with the business units, Legal, and Finance. This role will prepare internal renewal strategy materials, facilitate client-ready...
Category
Client Services
Job Locations US-Remote
ID 2024-13257
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.
Category
Audit - Healthcare
Job Locations US-Remote
ID 2024-13239
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...
Category
Engineering/IT
Job Locations US-Remote
ID 2024-13174
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...
Category
Strategy
Job Locations US-Remote
ID 2024-13159
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,...
Category
Engineering/IT
Job Locations US-Remote
ID 2024-13156
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...
Category
Engineering/IT
Job Locations US-Remote
ID 2024-13097
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.
Category
Client Services
Job Locations MX-Remote
ID 2024-12959
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.   This position is eligible to be REMOTE but must live in the Mexico City/Mexico...
Category
Engineering/IT
Job Locations US-Remote
ID 2024-12941
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....
Category
Audit - Retail
Job Locations US-Remote
ID 2024-12926
This is a technical role within Cotiviti’s IT Organization for a Jira and Confluence Architect. The ideal candidate will have a proven track record in designing, implementing, and managing Jira and Confluence Data Center products to meet complex business requirements. This role requires strong architectural expertise, hands-on experience, and the ability to optimize Atlassian products and secure Jira and Confluence environments.
Category
Engineering/IT
Job Locations US-Remote
ID 2024-12897
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...
Category
Product Management
Job Locations AU-NS-Sydney
ID 2024-12821
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.
Category
Engineering/IT
Job Locations US-Remote
ID 2024-12464
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.
Category
Engineering/IT
Job Locations US-Remote
ID 2024-12445
The Senior Auditor position is responsible for auditing client data on behalf of Cotiviti's clients and generating high quality recoverable claims for the benefit of Cotiviti and our clients. Responsible for conducting or assisting in the identification, validation, and documentation of moderate to more complex audit projects. Primarily responsible for mid to high auditing efforts by executing more independent projects assigned by the Audit Manager.
Category
Audit - Retail