The Senior Support Engineer is responsible for supporting and enhancing software applications within the Cotiviti product suite. This role involves analyzing complex business problems, resolving technical issues, and mentoring team members while ensuring project deliverables meet quality and budget standards.
The Support Engineer manages production recovery efforts, communicates with clients regarding technical issues, and acts as a liaison between operational and technical teams. They are also responsible for automating tasks, mentoring junior staff, and maintaining system documentation within an ITIL framework.
The Director leads early-stage solution strategy and innovation for emerging healthcare opportunities by bridging technical possibilities with commercial business needs. They collaborate across cross-functional teams to shape high-value solution pathways and ensure alignment with enterprise priorities and market evolution.
The Staff Accountant is responsible for preparing journal entries, account reconciliations, and variance analysis to support the monthly general ledger close. They also assist with audit requests, payroll system administration, and the documentation of internal controls.
The Enterprise Marketing Director is responsible for owning and executing the company's enterprise narrative, category story, and executive-facing positioning across all portfolios. This role also manages analyst relations, competitive intelligence synthesis, and executive support for high-visibility board and investor communications.
The Client Service Analyst supports the client-facing team by managing policy maintenance presentations, generating reports, and analyzing data. They also handle client inquiries, document decisions in software applications, and ensure accurate reporting for operational activities.
The Content Solutions Analyst is responsible for researching and analyzing medical policies to develop logic and algorithms for the payment policy library. They will collaborate with clinical and technical teams to ensure accurate coding and claims processing rules are implemented.
The Data Engineer is responsible for architecting, developing, and maintaining scalable data infrastructure and ETL/ELT pipelines. They will also implement data quality frameworks and manage semantic layers to ensure data accessibility for analytics and reporting.
The Senior Manager leads a quality-focused team to monitor and improve systems, ensuring the delivery of value to clients through robust governance and AI-enabled quality programs. They act as a vital link between technical experts and leadership, driving continuous improvement and proactively identifying emerging risks.
The Director of Audit Operations leads audit teams to ensure high-quality service delivery, operational efficiency, and client satisfaction. This role also manages account growth, contract renewals, and staff development while ensuring compliance with healthcare regulations.
The Payment Accuracy Specialist is responsible for auditing client data to identify and document recoverable claims while ensuring compliance with healthcare regulations. They also collaborate with the audit team to share knowledge, develop new claim concepts, and improve existing audit processes.
The Senior Software Engineer is responsible for supporting and enhancing high-quality software modules within the Cotiviti product suite. They will collaborate with cross-functional teams to resolve technical issues, document specifications, and mentor other developers.
The Data Solution Specialist will design, execute, and optimize data transformation processes while collaborating with stakeholders to integrate large healthcare datasets. They will also participate in all stages of project development, from research and design to programming, testing, and implementation.
The Client Policy Manager is responsible for maintaining the integrity of client medical payment policies and ensuring they are accurate and up-to-date. They act as a liaison between internal teams and clients, managing policy projects and conducting data analysis to support medical payment decisions.
The Yield Support Specialist performs administrative tasks such as data entry, filing, and report generation to support audit operations. They also serve as a point of contact for internal and external inquiries while ensuring compliance with regulatory standards and quality requirements.
The Events Coordinator supports the planning, logistics, and execution of internal and external events to align with business goals and brand standards. Responsibilities include managing attendee registration, vendor onboarding, budget tracking, and providing on-site support for event materials and staffing.
The Senior Auditor performs clinical quality assurance reviews of claims to ensure accuracy, compliance, and medical necessity. They also communicate findings to management and mentor other auditors to improve overall quality and productivity.
The Client Services Manager coordinates cross-functional teams to ensure client satisfaction, revenue retention, and successful implementation of payment policy products. They serve as the primary liaison, managing client relationships, strategic planning, and operational execution while identifying opportunities for growth.
This role involves performing retrospective clinical chart reviews on readmission and place of service claims using nationally accepted guidelines. The auditor will document findings, maintain production goals, and utilize proprietary systems to ensure accuracy and quality in claim identification.
The Data Solution Specialist manages project milestones, task execution, and process improvement initiatives while collaborating with cross-functional teams. They are responsible for data quality checks, documentation of client interfaces, and performing technical analytics to support healthcare data warehouse operations.
The specialist acts as a subject matter expert to conduct complex audits, identify overpayments, and ensure accurate coordination of benefits for healthcare clients. They are responsible for collaborating with team members, performing quality checks, and maintaining compliance with regulatory standards such as CMS and HIPAA.
The Senior Software Engineer is responsible for supporting and enhancing software modules within the Cotiviti product suite. They will collaborate with cross-functional teams to resolve technical issues, document specifications, and mentor other developers.
The Senior Manager leads the design, delivery, and continuous improvement of training programs for audit managers and quality staff across CCV. This role partners with cross-functional teams to translate evolving audit guidelines and AI capabilities into effective, measurable training interventions.
The Medical Director serves as a subject matter expert on coding and payment policy, directing the Medical Policy Committee and supporting client growth. They act as a clinical liaison to health plan clients, providing guidance on medical policy edits and identifying value-creation opportunities.
The Senior Technical Specialist is responsible for the intake, logic development, deployment, and maintenance of business rules within the company's platform applications. They act as a liaison between operations and the BRMS Center of Excellence while conducting root cause analysis to optimize rule performance and operational scalability.
Lead the design and development of Java-based backend services and AI-enabled workflow automation solutions. Provide technical leadership through mentoring, code reviews, and driving the adoption of AI-assisted development standards.
The Principal AI Engineer will lead the architecture and development of a centralized agentic AI platform for clinical use cases. They will drive technical vision, mentor engineering teams, and ensure compliance with regulatory standards across the software development lifecycle.
The Immigration Counsel will serve as an in-house legal advisor, managing immigration operations, visa caseloads, and ensuring compliance with federal and state laws. They will partner with HR and recruiting to execute sponsorship assessments and advise leadership on immigration-related business impacts.
The Principal Insights Analyst will lead strategic data analysis and modeling to drive operational performance and revenue growth within the healthcare payment integrity sector. This role involves cross-functional collaboration, mentoring junior analysts, and translating complex data into actionable insights for senior leadership.
The specialist is responsible for reviewing and analyzing claims, member, and group data to identify recoverable claims and establish correct liability order. They must also input accurate recovery information into proprietary software while adhering to regulatory guidelines and maintaining data confidentiality.
The Client Services Manager acts as the primary liaison for clients, managing operational implementation and execution of Fraud, Waste, and Abuse (FWA) programs. They are responsible for identifying client needs, facilitating meetings, analyzing performance trends, and developing action plans to ensure program success.
The Client Policy Manager manages client payment policies by ensuring accuracy, completeness, and alignment with industry updates. They act as a liaison between internal teams and clients, conducting research and analysis to maintain medical policy integrity.
The Research Medical Director provides leadership in developing and maintaining medical policies while ensuring accurate interpretation of clinical and payment guidelines. They are responsible for conducting research, performing data analytics, and educating client-facing teams on policy updates.
The Lead Sales Solutions Consultant will lead technical discovery, solution design, and architecture discussions to drive growth across Cotiviti’s healthcare payer solutions. They will support end-to-end pre-sales engagements, including demos, RFP responses, and cross-functional collaboration to ensure scalable and differentiated solution delivery.
The Senior Database Engineer will design, develop, and maintain database applications within the Cotiviti product suite while focusing on performance tuning for large-volume data sets. They will collaborate with global teams to drive application design and leverage AI-assisted tools to accelerate development and testing cycles.
The Senior Manager of Quality Audit Operations is responsible for overseeing and executing quality audit programs within a healthcare environment. They will lead operational initiatives to ensure compliance with regulatory standards and internal quality benchmarks.
The Senior AI Engineer will develop and evolve clinical NLP integration layers and golden dataset pipelines for a clinical AI platform. They will also implement agentic AI frameworks and collaborate with cross-functional teams to integrate AI solutions into customer-facing applications.
The Team Lead Senior Auditor oversees a team of clinical validation auditors to ensure productivity, quality standards, and accurate claims reporting. They are responsible for performance management, training, process optimization, and collaborating with management to meet client service level agreements.
The Medical Policy Release Manager oversees the planning, scheduling, and quality assurance of medical policy content and IT system updates. This role acts as a liaison between clinical, IT, and business teams to ensure compliance and minimal disruption during production deployments.
The ISSM is responsible for overseeing and sustaining the security authorization and continuous compliance of cloud-based information systems for federal customers. This includes managing FedRAMP authorization activities, maintaining security documentation, and coordinating with stakeholders to ensure adherence to NIST and federal requirements.
The Principal Product Manager will lead the strategy, development, and lifecycle of complex AI-enabled products within the Healthcare claims accuracy domain. They will drive cross-functional collaboration, align business objectives with technical execution, and mentor product team members to ensure successful AI adoption.
The Senior Director of Coding oversees strategic operations for Risk Adjustment coding, ensuring performance meets client expectations and quality standards. This role manages onshore and offshore teams, analyzes performance metrics, and collaborates with leadership to drive process improvements.
The Client Services Manager acts as the primary point of contact for clients, focusing on revenue retention, client satisfaction, and the operational execution of auditing programs. They manage cross-functional projects, monitor financial trends, and present operational results to internal and external stakeholders.
The Senior Implementation Consultant is responsible for configuring and implementing Edifecs solutions for payer systems on cloud platforms. They will manage technical integrations, develop mapping specifications, and provide post-implementation support to ensure client success.
The Integration Business Analyst will gather and document complex business requirements for risk adjustment solutions while coordinating across cross-functional teams. They are responsible for translating business needs into functional specifications and ensuring seamless integration between technology platforms.
The SVP of Enterprise Client Engagement and Strategy is responsible for owning commercial performance, multi-year area strategy, and driving revenue growth across a $300M+ book of business. This leader also manages executive-level client relationships and drives organizational change to ensure alignment with corporate objectives.
The Product Analyst is responsible for release planning, status reporting, and writing business requirements. They collaborate with teams to allocate resources, prioritize features, and track customer bugs.
The Counsel provides legal guidance on government and commercial contracting, focusing on healthcare regulatory frameworks and federal/state programs. They are responsible for drafting, negotiating, and managing complex agreements while ensuring compliance with legal and operational requirements.
The Senior Auditor performs contract compliance and cost control audits on various construction and capital projects. They are responsible for validating billed costs, identifying cost recoveries, and mentoring other auditors on audit engagements.
The Platform Systems Analyst acts as a liaison between business stakeholders and technical teams to translate requirements into actionable specifications. They are responsible for optimizing enterprise platforms, managing data flows, and ensuring system alignment with architectural and compliance standards.
The Senior Implementation Consultant will coordinate with clients to install, configure, and deploy Edifecs/Cotiviti solutions based on specific business needs. They are responsible for providing technical support, delivering product training, and mentoring internal teams throughout the implementation lifecycle.
The Senior Operations Engineer manages end-to-end operations for Edifecs application instances, including deployments, configuration, and performance monitoring. They provide L2/L3 technical support to enterprise clients and collaborate with cross-functional teams to resolve complex operational issues.
The Senior Software Engineer II will lead the design, development, and delivery of the Early Intervention Coordination of Benefits solution on a high-volume healthcare platform. They will provide technical leadership, mentor team members, and collaborate with architects to drive innovation and ensure system scalability.
The Senior Database Engineer is responsible for designing, developing, and maintaining database applications and reusable software components within the Cotiviti product suite. They will collaborate with global teams to drive application design, resolve performance issues, and implement innovative solutions to business problems.
You will develop and deploy machine learning and generative AI solutions to identify payment integrity issues and improve healthcare outcomes. This role involves collaborating with cross-functional teams to build end-to-end data pipelines and monitor model performance in production.
The Senior GCP Cloud Engineer will lead operational stability and reliability for cloud infrastructure, driving automation and incident response efforts. They will also mentor junior team members and collaborate cross-functionally to ensure scalable, secure, and resilient cloud platforms.
The Vice President of Sales is responsible for driving new business acquisition and strategic sales planning for Retail Payment Integrity Services. This role involves prospecting, managing multi-level client relationships, and collaborating with internal teams to deliver value-based solutions to large retail and e-commerce enterprises.
The Senior Software Engineer II will lead the development and improvement of high-quality software modules within the Cotiviti product suite. They are responsible for analyzing complex technical issues, mentoring junior engineers, and ensuring adherence to technology standards.
The Technical Specialist designs and develops logic for business rules within a BRMS to support healthcare platform applications. They are responsible for testing, deploying rules into production, and maintaining detailed documentation and impact reports.
Drive the planning, strategy, and roadmap for AI solutions and platforms across various lines of business. Manage end-to-end AI programs by coordinating with data science and engineering teams to implement scalable ML and Generative AI techniques.
Responsible for auditing inpatient claims to ensure coding accuracy and the appropriateness of treatment settings and services delivered. The role involves utilizing proprietary auditing systems to document results and identify potential recovery opportunities.
Design and implement a scalable agentic framework and centralized AI platform to support organization-wide AI initiatives. Collaborate with cross-functional teams to integrate AI agents into internal tools and customer-facing applications while ensuring security and scalability.
Design and implement the frontend for a centralized AI platform, focusing on intuitive interfaces for agent creation and monitoring. Develop reusable chatbot modules and responsive dashboards for integration across various SaaS products.
Develop and execute growth, renewal, and retention strategies for government customers while maintaining high-level relationships with C-suite executives. Lead a team to ensure customer satisfaction through proactive issue resolution and strategic account planning.
Design and implement scalable backend services and RESTful APIs for a centralized AI platform. Lead the development of agent lifecycle management while mentoring mid-level engineers and collaborating on technical architecture.
Perform clinical and coding audits for outpatient and specialty claims to ensure accuracy, medical necessity, and appropriateness of treatment. Document audit results and suggest process improvements to enhance recovery and client satisfaction.
Perform daily audits on client data to ensure coding accuracy and appropriateness for reimbursement. Respond to provider appeals and provide feedback to management to enhance product efficiency.
The Medical Policy Director serves as a subject matter expert in coding and medical payment policy to guide the Medical Policy Committee and health plan clients. They are responsible for analyzing client data to identify policy optimization opportunities and presenting these recommendations to drive value.
Defend recovery determinations by performing extensive reviews of initial claims and provider appeal documentation. Formulate written, reference-supported responses and provide educational feedback to the audit and QA teams.
The manager will identify opportunities to optimize retail audit processes and drive revenue growth through data-driven insights. They are responsible for managing the report development lifecycle and leading a team of professionals to improve internal and external customer satisfaction.
Lead the design and delivery of end-to-end ML/AI systems to optimize payment accuracy and risk adjustment using clinical and claims data. Define technical strategy, build evaluation frameworks, and mentor senior engineers to elevate organization-wide ML standards.
This role focuses on auditing inpatient claims for coding accuracy and clinical validation of DRG/APR-DRG. The auditor is responsible for documenting results, ensuring treatment appropriateness, and identifying new claim types for potential recovery.
Own the end-to-end product development lifecycle for healthcare enrollment initiatives, from discovery and roadmap planning to release execution. Act as the primary liaison between business stakeholders and engineering teams to translate regulatory needs into technical specifications.
Develop and execute growth, renewal, and retention strategies for top-tier healthcare customers. Act as the primary liaison and advocate for clients to ensure satisfaction and align product development with client needs.
The role focuses on model risk management, validation, and monitoring of GenAI models to improve healthcare outcomes. Responsibilities include benchmarking existing models, detecting model drift, and implementing Responsible AI frameworks.
Develop and deploy Generative AI and machine learning solutions to improve healthcare payment integrity and quality of care. Collaborate with stakeholders to assess business problems and build end-to-end data pipelines and models for production.
Perform DRG validation and clinical reviews for inpatient claims to ensure coding accuracy and appropriateness of treatment settings. Document audit results and utilize proprietary systems to generate audit determinations and letters.
Develop and deploy Generative AI solutions to improve healthcare payment integrity and quality of outcomes. Collaborate with stakeholders to assess AI use cases and integrate models into the company's machine learning platform.
The Data Engineer is responsible for creating and optimizing SQL scripts to manage data implementations, production, and quality. They collaborate with engineering and DBA teams to troubleshoot environmental issues and maintain data integrity compliance.
Conduct research on Generative AI and AGI for healthcare treatment, payment, and operations use cases. Develop AI models, architectures, and systems while contributing to AI governance and academic collaborations.
Oversee the data engineering efforts to provision scalable, reliable data pipelines and lead a team of data engineers in delivering quality code and building data products. Establish a metrics-driven approach to measure team performance and influence the vision for the data engineering platform.
Design and evolve intelligent workflow and automation solutions using AI-native development tools and open-source engines. Establish architectural standards and lead a Center of Excellence for AI-enabled workflow development to ensure scalable and secure solutions.
Lead multiple software engineering teams to deliver high-quality solutions using an AI-native approach to accelerate delivery and improve effectiveness. Partner with cross-functional stakeholders to align technology execution with business priorities and healthcare compliance requirements.
Lead the architectural design and execution for a specific business area, translating product intent into implementable specifications for AI-native solutions. Orchestrate AI agents and engineering workflows to deliver scalable, secure, and maintainable applications within a regulated healthcare environment.
Investigate suspected healthcare fraud, waste, and abuse using data analytics and claims review to identify atypical billing patterns. Report findings through written summaries and support legal proceedings by testifying in court or collaborating with law enforcement.
Design and build the backend infrastructure and scalable RESTful APIs for a centralized AI platform. Lead the development of Python/Java SDKs and manage the lifecycle of AI agents within a multi-tenant architecture.
Automate the build-test-deploy lifecycle for cloud applications and enhance platform services within an agile environment. Collaborate with cross-functional teams to implement software configuration management best practices and maintain a secure, high-availability SaaS platform.
Oversee the full lifecycle of strategic partnership and vendor contracts, including drafting and negotiating complex commercial agreements. Advise internal stakeholders on legal risks, contract interpretation, and compliance requirements.
Oversee business operations within the Payment business unit to support sales, client engagement, and operational efficiency. Lead team development and implement strategic improvements to meet or exceed service level benchmarks.
Drive new logo acquisition by selling pharmacy claim editing and payment accuracy solutions to U.S. health plans and TPAs. Lead complex sales cycles and develop strategic account plans to expand market share within assigned territories.
Responsible for researching and analyzing medical policies to create clinical coding and pharmacy claims editing logic. The role involves collaborating with developers and product teams to implement rule enhancements and ensure operational alignment.
The Director of Quality oversees the delivery and performance of payment integrity solutions by implementing quality measurement frameworks and driving continuous improvement. They collaborate with cross-functional teams to optimize operational processes, manage talent, and ensure service level benchmarks are consistently met or exceeded.
The Project Manager owns the end-to-end delivery of projects, ensuring plans are realistic and stakeholders are aligned. They are responsible for maintaining project artifacts, managing RAID logs, and facilitating team meetings to ensure execution stays on track.
Define and govern the end-to-end technical architecture for a mission-critical CMS audit platform while leading its AI-native transformation. Lead, mentor, and elevate a cross-functional engineering team while ensuring robust, scalable, and secure technical solutions.
Identify, investigate, and analyze instances of potential healthcare fraud, waste, and abuse through data analysis and interviews. Prepare written summaries of findings, conduct training, and support legal proceedings or settlement negotiations.
The intern will research and develop autonomous Agentic AI systems to improve healthcare treatment, payment, and operational workflows. They will also assist in establishing an Artificial Intelligence Governance Program and collaborate with cross-functional teams on AI model development.
The AI Program/Project Manager will lead the development and deployment of AI/ML solutions by collaborating with cross-functional teams to define project scope and roadmaps. They are responsible for driving data-driven decision-making and ensuring the successful integration of models into production environments.
The Technical Customer Solutions Manager will act as a trusted advisor to healthcare payer clients, managing project plans and ensuring the effective use of Cotiviti products. They will lead account relationships, track operational metrics, and collaborate cross-functionally to drive client success and product enhancements.
The AI-Native Product Lead owns the single-team product backlog, translating business needs into clear, testable requirements while ensuring continuous backlog readiness for fast, iterative delivery. This role provides essential product intent and grounding context to guide both human and AI-assisted development workflows.
The Vice President will devise and execute strategy for new business opportunities within the Federal and State Government Healthcare markets, driving revenue through new contract awards with agencies like the VA, DHA, and CMS. This involves managing the full business development cycle, achieving sales targets, and maintaining key customer relationships.
