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Cotiviti
Cotiviti
11 open remote positions
Cotiviti is a healthcare technology company that provides analytics and payment accuracy solutions. It operates globally with a focus on innovation and collaboration, employing a diverse team dedicated to improving healthcare outcomes.
Salary Distribution
2 of 11 jobs
PTO Distribution
9 of 11 jobs
Benefits Overview
10 of 11 jobs
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Open Positions
Lead the vision and strategy for Edifecs University training and certification programs. Collaborate with product, engineering, and sales teams to develop innovative training assets. Oversee P&L, operations, and team development to drive business outcomes.
Leadership
Instructional Design
LMS Management
Strategic Planning
Define the product strategy and roadmap for the FWA product suite, including rules-based and AI-driven solutions. Collaborate with analytics, data science, and operations teams to enhance detection capabilities. Balance strategic goals with execution, managing trade-offs across stakeholders in a matrixed organization.
Product Management
Healthcare
Data Analytics
Cross-Functional Collaboration
Investigate suspected incidents of healthcare fraud, waste, or abuse through data analysis and interviews. Analyze information, report findings, and recommend settlements or denials while supporting legal proceedings. Conduct training on fraud detection and maintain knowledge of relevant laws and regulations.
Excel
Data Analysis
Investigation
Communication
Attention To Detail
Analyze and audit inpatient claims for DRG validation, coding accuracy, and clinical appropriateness without a medical record. Utilize proprietary auditing systems to make determinations and generate audit letters, meeting productivity and quality standards. Identify new claim types and suggest process improvements while maintaining expert ICD-10 and DRG coding knowledge.
ICD-10
Medical Coding
Auditing
Perform analytics for Risk Adjustment operations, including PR calculations and HCC metrics. Write SQL queries and develop Tableau dashboards to visualize healthcare data. Assist with NLP projects and AI initiatives to enhance medical data processing.
SQL
Tableau
Excel
Healthcare Analytics
Data Visualization
Conduct research and quality assurance for drug and biological policies. Write business logic and translate industry references into Cotiviti policy. Mentor new team members and assist with customer inquiries regarding clinical rules.
CPT
HCPCS
Build and enhance production-grade software applications using AI-assisted development workflows. Design and implement clean, well-structured APIs, services, and application components. Collaborate closely with the AI-Native Tech Lead to implement engineering best practices and deliver features end-to-end.
Java
.NET
Python
SQL
CI/CD
Design scalable, secure, and maintainable workflow solutions aligned to business needs and AI-driven decisioning. Leverage AI tools (Claude, Copilot) to accelerate design, code generation, and documentation with strong validation. Contribute to a Workflow CoE, driving governance, reusability, performance, and AI-native standards.
Java
AI-assisted Development
CI/CD
Cloud Platforms
Direct audit service delivery and manage teams to meet client needs and exceed expectations. Drive audit productivity, cost management, and continuous improvement through metrics and innovation. Lead staffing, people management, and contract negotiations to ensure compliance and growth.
Operations Management
Client Services
People Management
Drive new sales growth within Cotiviti’s National Accounts segment. Identify and advance enterprise health plan opportunities by expanding executive relationships. Lead complex, multi-stakeholder sales pursuits from prospecting through negotiation.
Sales
Healthcare
Account Management
Strategic Planning
Supports the Retrieval Operations team with new technology initiatives and system issue triage. Develops and delivers progress reports, proposals, and requirements documentation. Manages project dependencies, critical paths, milestones, and deliverables.
Project Management
Process Improvement
Change Management
Communication
Analytical Thinking