Cotiviti

• Design and develop high quality, maintainable software modules for the Cotiviti, Inc. product suite • Conduct unit and integration testing using appropriate methodology and techniques • Analyze requirements and specifications and create detailed designs for implementation • Analyze and resolve software related issues originated from internal or external customers • Continuously update professional knowledge of new technologies as selected and integrated into the Cotiviti, Inc. product suite • Review software engineering approach to proposed solutions to ensure adherence to best practice • Mentor team members in proper software engineering methods and techniques

• Implement new policies and update existing policies for clients to ensure the policy is editing in accordance with the industry and per the client’s expectation • Write and design client requested policies from scratch, translating client expectations into Cotiviti guidelines to ensure appropriate configuration • Execute projects requests, design work orders, and actively monitor queues to ensure all requests are completed by the desired completion date • Balance multiple priorities and manage projects deliverables for two or more healthcare clients • Proactively assist on other client accounts where needed • Provide the highest level of customer service by documenting and staying current regarding all client sensitivities and configuration needs • Investigate situations where configuration updates conflict with client customizations or needs • Meet daily and monthly production and quality targets; maintaining an exemplary level of accuracy in all work; ensuring that the capture and completion of assigned projects are audited and that corrections are made where needed • Perform regular quality checks to ensure accuracy for all a client’s policy set by analyzing quality reports and troubleshoot results, determining root cause(s) and promptly resolving • Perform Peer Review responsibilities by providing feedback to peers assisting in achieving department quality goals • Receive peer feedback, identifying any trends and proposing concise solutions to minimize error rate • Resolve testing issues and conflicts related to policy configuration updates and policy overlaps • Analyze pre and post client claim data to ensure appropriate claim editing • Participate in client presentations by providing configuration expertise and capturing client decisions • Coordinate and manage post-client presentation activities • Maintain detailed and up to date knowledge of internal applications, actively participating in all trainings and software release meetings • Communicate effectively and timely with upstream functional areas to resolve issues

Role Description 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. This role 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 Coordination of Benefit claims for the benefit of Cotiviti and our clients. - Works under limited supervision and is responsible for establishing the correct order of liability for our client’s members. - Inputs accurate claim recovery information in the proprietary Cotiviti software tools. - Assists with related inquiries throughout the claim recovery process. - Handles moderate to more complex audit projects, ranging from low to midrange in scope. Responsibilities - Monitored for efficiency in production and quality review of assigned work. - Demonstrates the ability to excel both independently and as a collaborative team player. - Involves complex member selections and multi-client impacts. - Runs and establishes queries and filters for construction and data reports. - Demonstrates proactive problem-solving skills and resolves data-related challenges efficiently. - Possesses in-depth knowledge of CMS and NAIC guidelines for determining liability accurately. - Utilizes Cotiviti audit tools (RMS, COB Tracker, specific client systems) to complete member investigations. - Creates detail-oriented, accurate notes in Cotiviti audit tools and/or client tools throughout the member investigation. - Meets or exceeds standards of production and quality as identified by compliance and regulatory guidelines. - Prepares and evaluates responses to client disputes both internally and externally. - Identifies opportunities for continuous improvement for efficiencies within reporting and streamlining research processes. - Demonstrates understanding of Cotiviti policies & procedures and external regulatory requirements. - Assures confidentiality and security of all data, adhering to HIPAA laws and requirements. - Takes responsibility for outcomes and applies learning as applicable. - Integrates information from various sources and considers broader context. - Creates innovation to enhance the standard operating rhythm. - Actively seeks information to understand rationale and provide exceptional results. Qualifications - High School Diploma - Required. - Bachelor’s degree (Preferred) and/or a minimum of at least two (2) years related experience in healthcare. - At least 1-2 years of Cotiviti experience is recommended for individuals seeking their next opportunity internally. - Healthcare industry experience, including knowledge of Coordination of Benefits (Required). - Computer proficiency including Microsoft Office (Word, Excel, Outlook). - Excellent verbal and written communication skills. - Strong interest in working with large data sets and various databases. - Ability to work well in an individual and team environment demonstrating self–motivation to deliver success. Requirements - Ability to analyze large volumes of data, identify trends, discrepancies, and anomalies. - Exceptional attention to detail to ensure accuracy in financial records and audit findings. - Strong critical thinking skills with the ability to assess complex situations and propose practical solutions. - Makes informed decisions based on available data, regulations, and auditing standards. - Strong understanding of auditing standards, regulations, and industry best practices. - Ability to recognize when something is wrong or needs further investigation. - Ability to work effectively as part of an audit team, sharing insights and collaborating on tasks. Physical Requirements and Working Conditions - Remaining in a stationary position, often standing or sitting for prolonged periods. - Repeating motions that may include the wrists, hands, and/or fingers. - No adverse environmental conditions expected. - Must be able to provide a dedicated, secure work area. - Must be able to provide high-speed internet access/connectivity and office setup and maintenance. Benefits - Base compensation ranges from $22.60 to $26.00 per hour. - Eligible for discretionary bonus consideration. - Nonexempt employees are eligible to receive overtime pay for hours worked in excess of 40 hours in a given week. - Competitive benefits package including medical, dental, vision, disability, and life insurance coverage. - 401(k) savings plans. - Paid family leave. - 9 paid holidays per year. - 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service.

• Partner with business leaders, Operations, Business Architecture, PMO, Training/Change Enablement, and R&D to elicit and understand business priorities, operational pain points, and capability needs • Translate business needs into clear epics, features/intent, user stories, acceptance criteria, process requirements, and delivery-ready backlog items that enable AI-native workflows • Identify dependencies, risks, gaps, and tradeoffs early, escalating when decisions are needed • Own and maintain the prioritized backlog for assigned initiatives, capabilities, or product areas • Ensure requirements are clear, testable, aligned to business outcomes, and ready for R&D execution • Drive continuous delivery & continuous deployment by shaping high-quality inputs, aligning priorities, validating outputs, and ensuring readiness for release and adoption • Serve as the day-to-day point of clarification for R&D teams during delivery • Partner with Business Architecture to ensure current-state and future-state processes are reflected in requirements and solution design • Work with Training and Change Enablement to ensure impacted teams are prepared for new capabilities, process changes, releases, and adoption • Support CI/CD readiness by helping improve requirement quality, release discipline, stakeholder alignment, and adoption planning • Help drive adoption by ensuring delivered capabilities meet business needs and are understood by end users • Track business value, adoption, issues, feedback, and continuous improvement opportunities after release • Complete all responsibilities as outlined in the annual performance review and/or goal setting • Complete all special projects and other duties as assigned

Role Description Opening available for Software Engineer - Dev Retrieval Platform at Cotiviti, Inc. in South Jordan, UT. - Design, develop, and maintain software applications and reusable components for Cotiviti’s product suite, adhering to SDLC phases and coding standards. - Build front-end web applications, ensuring responsive and accessible design. - Develop modern user interfaces and maintain robust back-end systems leveraging SQL Server and other relational databases. - Troubleshoot and resolve software issues reported by internal and external customers, following structured analysis. - Implement enhancements to improve performance, scalability, and availability. - Communicate technical and operational issues clearly to engineering and business leadership. - Ensure adherence to technology standards, code reviews, and quality assurance practices throughout the development lifecycle. - Contribute ideas to improve processes, systems, and overall efficiency. - Stay current with emerging technologies and integrate them into Cotiviti products. - Execute all phases of the SDLC, including requirements analysis, design, coding, testing, deployment, and maintenance, with a focus on continuous improvement. - Collaborate effectively with senior developers, offshore teams, and cross-functional stakeholders. Qualifications - Requires a bachelor’s degree or equivalent in Computer Science or related field. - Five (5) years of experience architecting, designing, developing, and modifying application systems utilizing .NET Core and Angular framework. - Five (5) years of software development experience with ASP.NET, MVC, C#, XML, JSON, HTML, Angular, TypeScript, CSS, and JavaScript. - Five (5) years of experience with Agile/Waterfall SDLC and Scrum. - Five (5) years of experience with Cloud technologies including Azure Network/Cloud and AWS. - Five (5) years of experience with CI/CD pipeline tools. - Five (5) years of experience with SQL Server or other relational databases. - Five (5) years of experience with .NET framework. - Any and all experience may be gained concurrently. - Telecommuting available anywhere in the U.S. Benefits - Base compensation ranges from at least $152,402. - Competitive benefits package including medical, dental, vision, disability, and life insurance coverage. - 401(k) savings plans. - Paid family leave. - 9 paid holidays per year. - 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti.

Role Description Opening available for Senior Manager, Analytics at Cotiviti, Inc. in South Jordan, UT. - Lead the development of analytics and Opportunity Analysis (OA) that drive optimization and grow company revenue. - Maintain and operate multiple-rule engines for the optimization process across the Cotiviti product suite. - Serve as the product owner for the Rule Value Analysis (RVA) platform and champion its adoption and enhancement roadmap. - Lead data modernization efforts for the Business Unit. - Manage a team of Data and Insight Analysts, including responsibility for their training and development. - Work closely with the product team supporting the development and evaluation of new products. - Assist with the definition of data requirements for specific dashboard/reporting projects and partner with internal teams as needed to obtain support for those requirements. - Review for accuracy all dashboards and reports before they are shared with clients and provide additional analysis or insight to add value to the metrics. - Responsible for establishing, standardizing, and automating reporting and analysis tasks to maximize efficiency. - Regularly review and evaluate opportunities to improve the reporting and analytical processes to achieve a higher maturity of performance management. - Provide ongoing updates and support around optimization efforts to various leaders across the organization. - Oversee the environment used to process Opportunity Analyses and partner with Research and Development on ensuring its availability. - Hire, develop, coach, lead, and retain top-tier talent, with a focus on building and improving a team and culture that can assist in employing best in class practices to support and drive high levels of internal and external customer satisfaction. Qualifications - Requires a bachelor’s or foreign equivalent degree in Computer Science, Statistics, Data Analytics, or related field plus 6 years of experience delivering actionable insights from data analytics. - In lieu of a bachelor’s or foreign equivalent degree and 6 years of experience as stated, employer will accept a master’s or foreign equivalent degree and 3 years of experience as stated. - Also requires 3 years of experience in the following areas: - Working in a Hadoop-based big data environment. - Data visualization and dashboarding. - Tableau. - Scripting languages including T-SQL and Python. - SQL syntax for multiple databases. - Jira. - Working with U.S. healthcare claims data. - Big data analysis techniques, including Pig, HDFS, and Spark. - Using statistical methodology to solve business problems. - Properly handling Protected Health Information (PHI). - Documenting project scope, process, owners, milestones, and timelines. - Creating reports for a variety of audiences. - Experience may be, but need not be, acquired concurrently. - Telecommuting available anywhere in the U.S. Requirements - Base compensation ranges from at least $201,406.00. - Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs. Benefits - Competitive benefits package to address a wide range of personal and family needs, including: - Medical, dental, vision, disability, and life insurance coverage. - 401(k) savings plans. - Paid family leave. - 9 paid holidays per year. - 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti.

• Conduct Sales Development activities using the telephone, email, CRM, and other web-based platforms • Proactively seek new account relationships through an outbound engagement process • Collaborate with Sales VPs to develop and execute account-level sales strategies • Qualify prospective customers using solution-selling techniques • Develop thorough prospect profiles of target accounts • Participate in sales meetings, pipeline reviews, marketing input sessions and other sales events • Contribute to a professional atmosphere through positive interaction with customers and co-workers

• Define system architecture for AI/LLM-powered products end to end over claims, medical records, and clinical documentation. • Build and own evaluation frameworks (LLM-as-a-Judge, offline metrics, online experiments) aligned to accuracy, auditability, and clinical and regulatory risk. • Drive the data flywheel: convert expert clinician and auditor review decisions into high-quality labeled data. • Lead ranking and prioritization systems that surface the highest-value claims, audits, and care gaps for human review. • Establish reusable platform patterns — shared context stores, evaluation harnesses, feature pipelines.

• Develop and maintain project plans, milestones, RAID logs, and status reporting • Facilitate team meetings, decisions, issue resolution, and stakeholder follow-up • Coordinate scope, schedule, resources, communications, and delivery readiness • Escalate risks and tradeoffs in a timely manner • Ensure project artifacts, governance requirements, and documentation are complete • Own one project’s scope, timeline, and execution discipline • Utilize AI responsibly to amplify productivity • Share best practices with project managers, product owners, and business analysts as appropriate • Proactively manage risks and issues, and escalate in a timely manner

Role Description The focus of the AVP, Account Management - GOV is to develop and execute against growth, renewal and retention strategies on all customers within Cotiviti Government Services (CGS). The VP, Account Management 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. Responsibilities - Develop, foster, and maintain relationships with customer accounts. - Liaison between company and client or prospect; serves as the client’s/prospect’s advocate. - Monitor and support all activity and manage problem resolution, escalating customer issues quickly if necessary. - Responsible for managing, tracking, and closing all client issues. - Overall client relationship management and internal coordination to achieve customer satisfaction for existing client contract(s). - Provide client support for established elements of customer satisfaction. - Develop and maintain account management plans. - Meet regularly with client (weekly, monthly, quarterly) to assess account status and progress, client needs and feedback, address issue resolution, and discuss enhancements or account growth opportunities. - Ensure effective communication with clients regarding new audits, edits, system issues, and upgrades. - Communicate any client needs/ideas for future development to meet client’s requirements and expectations. - Review client reporting to manage, monitor, and identify potential problems. - Develop and oversee routine client reporting, including but not limited to Quarterly Business Reviews (QBR’s), weekly status reports, and steering committee updates for GOV customer base. - Travel to clients and prospective clients as required to strategically manage client relationships and optimize use of core service offerings. - Proactively monitor client needs and actively solicit requests for additional services and improvements to current services. - Ensure customer satisfaction by resolving issues quickly and creatively. - Interact with operations and marketing/sales to communicate notable client trends. - Synthesize and articulate key findings for operations, sales, finance, and product development and executive audiences using sound financial and market analysis. - Proactively present strategic recommendations. - Work closely with sales, operations, and management to ensure ongoing customer satisfaction. - Team with sales executives to identify sales opportunities and provide support. - Report weekly to Senior Leadership on overall client satisfaction levels, new client issues, unresolved client matters, and customer requested needs. - Assist with various marketing efforts, including attending tradeshows/conferences, participating in webinars, and responding to RFPs. - Experience with hiring, developing, coaching, leading, and retaining top-tier talent. - Complete all responsibilities as outlined on annual Performance Plan. - Complete all special projects and other duties as assigned. - Must be able to perform duties with or without reasonable accommodation. Qualifications - B.S. or M.B.A. in Business Administration or related degree is required. - Strong working knowledge of health insurance industry business operations is required. - Senior executive with proven experience in growing and developing business in the health care information and analytics space. - Strong competencies in strategic planning, operations, marketing, product management, and business planning. - Master’s degree preferred. - Fifteen (15) years’ experience required in the health care industry. - Strong presentation skills, customer (internal/external) problem diagnostics and solution design. - Tactical scheduling, strong contract knowledge, and HIPAA compliance related to company’s Business Associate classification. - Demonstrated ability to maintain high level of ethics. - Excellent communicator and leader who is results-oriented and diplomatically assertive. - Ability to synthesize and utilize data, mentor staff, and be a successful team builder. - Establish professional relationships at all levels of key client organization, including C-level executives, vice presidents, and department managers. - Understand client’s strategic objectives and assist client in positioning Cotiviti's products into their long-term goals. - Demonstrable knowledge of healthcare claims payment policy and processing, claims editing, and fraud detection. - Strong customer engagement skills required with ability to establish and maintain multi-level customer relationships. - Willingness/availability to travel up to 15%, as required. - Strong interpersonal skills required; able to anticipate, identify and resolve simple to complex problems. - Proactive individual with strong troubleshooting skills. - Strong written and oral communication skills required. - Demonstrated ability to multitask in a fast-paced environment. - Excellent personal computer skills in Microsoft Word, Excel, PowerPoint, Outlook. Requirements - Problem-solving and critical thinking. - Completing tasks independently. - Making timely decisions in the context of a workflow. - Maintaining focus. - Assessing the accuracy, neatness, and thoroughness of the work assigned. Working Conditions and Physical Requirements - Remaining in a stationary position, often standing or sitting for prolonged periods. - Repeating motions that may include the wrists, hands, and/or fingers. - Must be able to provide a dedicated, secure work area. - Must be able to provide high-speed internet access/connectivity and office setup and maintenance. - No adverse environmental conditions expected. Benefits - Base compensation ranges from $180,000 to $210,000 per year. - Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs. - This role is eligible for commission. - Cotiviti offers a competitive benefits package including medical, dental, vision, disability, and life insurance coverage. - 401(k) savings plans, paid family leave, 9 paid holidays per year, and 17-27 days of Paid Time Off (PTO) per year. - For information about our benefits package, please refer to our Careers page. Company Description Since this job will be based remotely, all interviews will be conducted virtually. Date of posting: xx/xx/2026 Applications are assessed on a rolling basis. We anticipate that the application window will close on xx/xx/2026, but the application window may change depending on the volume of applications received or close immediately if a qualified candidate is selected. #LI-REMOTE #LI-AK1 #director