Cotiviti

Business Analyst

• Utilize BI tools to enhance and support existing reporting/data warehouse environment, including use of SQL Management Studio, SSRS, SSIS, PowerShell and Power BI and Tableau.
• Support the Retail/Cotiviti management and other stakeholders in evaluating, defining, standardizing, and reporting on key KPI's.
• Provide expertise for the design and requirements for both executive and client facing reports, scorecards, and dashboards.
• Design and implement data visualization dashboards and reports to effectively communicate insights to stakeholders at all levels of the organization.
• Manage development lifecycle of report generation (development, test/QA, UAT, bug fix/retest cycles)
• Utilize advanced analytical techniques to uncover trends, patterns, and correlations within large and diverse data sets.
• Interpret analysis results and translate them into actionable recommendations for business stakeholders.
• Conduct deep-dive analysis and root cause investigations to address complex business challenges and opportunities.
• Collaborate with cross-functional teams including marketing, sales, product development, and finance to understand business objectives and priorities.
• Present findings, recommendations, and insights to senior leadership and key stakeholders in a clear, concise, and compelling manner.

Senior Insights Analyst – Retail

Full-stack Engineer

• Implement data storage solutions and architectures for AI/ML workflows.
• Develop integration patterns between various data platforms and systems.
• Build scalable data processing pipelines using distributed computing frameworks.
• Create data quality and validation frameworks for ML pipelines.
• Design and implement ETL processes for model training data preparation.
• Support performance monitoring and optimization of data infrastructure.
• Implement security configurations and access controls for data platforms.
• Develop data lineage tracking and metadata management solutions.
• Build event streaming integrations for real-time data processing.
• Create automated testing frameworks for data pipeline validation.
• Document technical implementations and integration patterns.
• Collaborate with data scientists on data access and processing requirements.

Senior Software Engineer

• Design and architect the overall MLOps platform
• Lead security and authentication integration across systems
• Establish technical standards and architectural guidelines
• Drive technology selection and roadmap creation for the platform
• Conduct executive business reviews and manage stakeholder relationships
• Lead solution architecture and ROI analysis for the platform

Principal Software Engineer

• Lead the development of MLOps infrastructure components
• Oversee the integration of various MLOps tools (MLFLOW, Kubernetes, etc.)
• Manage implementation timeline and resource allocation
• Design APIs for ML services and system integration
• Lead deployment automation and pipeline orchestration
• Conduct feedback collection and manage improvement cycles

Lead Software Engineer

Data Scientist

• Lead the design of advanced predictive models for Claims Operations
• Oversee feature engineering and model development
• Design analytical frameworks for data driven decision making
• Establish evaluation frameworks for model performance and accuracy
• Lead knowledge transfer and mentorship for AI/ML techniques
• Drive innovation in analytics approaches and methodologies

Lead Data Scientist

• Lead development of Intelligent Claims Routing models.
• Design complexity scoring engine and optimal routing algorithms.
• Develop dynamic priority scoring algorithms for optimal workflows.
• Create documentation and training for AI features.
• Support expansion planning and optimization for AI systems.
• Lead user enablement and training initiatives.

Senior Data Scientist

• Develop classification and prediction models.
• Create pattern recognition systems for claims processing.
• Build optimization components for workflow efficiency.
• Implement evaluation metrics for model quality.
• Support user enablement and training.
• Assist with model documentation and knowledge transfer.

AI Engineer

• Design and implement scalable agentic solutions for diverse use cases
• Leverage a broad stack of Open Source AI technologies to build and maintain a centralized AI platform with unified APIs for cross-functional team access and build various types of agents
• Work with Product Engineers to integrate AI agents into customer-facing applications and internal tools
• Lead technical discussions, mentor junior engineers, and help set the technical vision for the AI platform roadmap.
• Ensure compliance with security, privacy, and regulatory requirements across the software development lifecycle.
• Optimize performance of AI-powered workloads across compute and storage layers using cloud-native and open-source solutions.
• Conduct performance analysis and capacity planning to ensure platform scalability

Principal AI Engineer

• Implement and maintain components of agentic AI framework under the guidance of senior engineers
• Leverage open-source AI frameworks (e.g., LangChain, CrewAI, AutoGen) to build and experiment with agents for diverse use cases
• Incorporate selected open-source solution into our agentic AI framework
• Collaborate with product engineers to integrate AI agents into customer-facing applications and internal tools
• Write clean, maintainable Python code for AI workflows, APIs, and data integration tasks
• Assist in testing, debugging, and improving performance of AI-powered workloads
• Contribute to documentation and knowledge sharing across the team

Senior AI Engineer

Implementation Specialist

• Coordinate and communicate with the client post-sale to develop an implementation plan for implementing and configuring a purchased Edifecs/Cotiviti solution based upon a client’s individual needs
• Collaborate with the Edifecs/Cotiviti Implementation Architect / Technical Project Manager to formulate the architecture, implementation strategy/schedule and operational plan
• Install, upgrade and configure Edifecs/Cotiviti products at client site
• Integrate Edifecs/Cotiviti products with other software assets/processes at customer site
• Coordinate with other Client Services, Product and Development team members to meet development and configuration milestones
• Develop guidelines, programs, tasks, reports, and documentation to meet the client’s requirements
• Provide post-implementation support during the transition from implementation to maintenance
• Provide software and client specific training, and develop training documentation
• Mentor and train internal teams upon Edifecs/Cotiviti products and customer custom components
• Work with customer as a SME upon purchased Edifecs/Cotiviti products and solutions
• Deliver product training and participate in customer-specific requirements development and deployment
• Manage or participate in testing and release cycle tasks for deployment of products and services at client sites
• Create detailed user and operational documentation to support the deployment of products and services at client sites

Senior Implementation Consultant

Operations

• Manage end-to-end operations for Edifecs hosted or customer-hosted Smart Trading application instances including deploying upgrades and configuration changes
• Manage day-to-day submission operations, build custom tools and utilities, and create ad hoc reports/queries
• Provide technical support to enterprise clients related to technical and operational aspects of the products
• Partner with IT SaaS team to design, deploy and manage Docker containers and Kubernetes clusters and integrate with Edifecs Products
• Partner with Product and Engineering teams to obtain EKS-compatible builds
• Collaborate with developers and system administrators to optimize application performance and scalability
• Develop and maintain CI/CD pipelines for automated testing, deployment, and monitoring of containerized applications
• Troubleshoot and resolve issues related to containerized environments, Kubernetes clusters, and related infrastructure
• Analyze application and database performance, identify bottlenecks, and report/fix issues with development teams
• Provide workarounds or temporary fixes to clients to avoid processing disruption
• Proactive management of submission cycles and reactive management of customer-reported cases/issues
• Plan and execute file submissions workflow including schedule management, batch management, file monitoring, and potential automation
• Reproduce customer issues in controlled test environments and follow standard operational procedures for case management
• Continuously improve troubleshooting skills and update knowledge base with reusable documentation

Senior Operations Engineer

• Works with enterprise customers of Edifecs/Cotiviti Encounter Management (EM) products to assist with post-sales installation, configuration, upgrade, troubleshooting and day-to-day operational management
• Triage and resolve highly complex technical and application-related issues impacting product performance in customer-specific environments
• Partner with Development, Sustaining Engineering, Product Implementation and Sales Engineering to resolve support issues, document bugs, provide UAT on product builds, and ensure successful server installations
• Provide support to enterprise clients related to technical and functional aspects of the products
• Assist Product and Development teams with performance and functional analysis and testing during release cycles of service packs, hot fixes, etc.
• Implement and maintain automation scripts for routine tasks
• Perform regular upgrades, migrations, code fixes and hot fix deployments
• Host online troubleshooting and investigation sessions on customer production environments
• Collect necessary problem details from customers and drive effective RCA to resolution
• Reproduce customer issues in controlled test environments
• Develop custom utilities and workarounds to resolve critical customer issues
• Consistently deliver responsive customer experience and manage escalations
• Provide mentorship and task guidance to other team members

Operations Engineer

Principal Software Engineer, Full Stack

Product Analyst

• Act as a bridge between business stakeholders and development teams.
• Define product requirements, prioritization and feature validation for delivery of features in agile environment.
• Collaborate with customers and internal stakeholders to capture product/business requirements.
• Translate business needs to clear user stories and maintain a healthy product backlog.
• Participate in agile ceremonies.
• Support product backlog prioritization.
• Collaborate with UI/UX designers.
• Track and document customer concerns to collaborate internally for resolution.
• Assist with product release planning and creation of supporting documentation.
• Prepare status reports.
• Track customers’ bugs.
• Manage release risks.
• Manage help topics, create release notes.

Solutions Engineer

• Edifecs/Cotiviti/Cotiviti is seeking a Data Integration Engineer to join our innovative software teams.
• Responsible for onboarding customers to the Risk Adjustment workflow applications.
• Work with platform engineering, product, and implementation teams.
• Build scalable data pipelines that enable workflow applications, reporting, and customer confidence.
• Strong, hands-on technical expertise in big data technologies and communication abilities with non-tech and technical audiences.
• Design and develop data flows and extraction.
• Integrate client’s data into the Edifecs/Cotiviti/Cotiviti Risk Adjustment.
• Work with relational databases and Python.
• Implement open-source standards for data.
• Develop a new framework for data ELT jobs to scale implementation, monitoring, and.
• Build and scale automation that orchestrate complex.
• Ability to support existing processes while leading efforts to redefine the data.

Data Integration Engineer, Risk Adjustment

Support Engineer

Manage and troubleshoot Linux servers in production environments.
Develop and maintain automation scripts using Bash or Python.
Collaborate with cross-functional teams to deploy, configure, and support applications.
Monitor system performance and proactively resolve issues to ensure high availability.
Plan and execute system upgrades, patches, and migrations.
Maintain Git repositories and enforce version control best practices.
Participate in on-call rotations to address critical system issues.
Document system configurations, operational procedures, and troubleshooting guides.

Backend Engineer

• The Product Analyst will contribute to the development and enhancement of a pre-encounter solution within Risk Adjustment Product team.
• Work closely with internal stakeholders and customer-facing teams, gather and document requirements from internal and external stakeholders, support new customer implementations, track regulatory updates and ensure the solution aligns with both business objectives and compliance standards.
• Elicit and validate requirements from internal and external customers, document analysis, workflow definitions, use cases, scenarios based on Edifecs product specifications
• Translate business needs into detailed documentation and user stories, actively participate in grooming sessions with the scrum team
• Conduct sprint planning, backlog prioritization, and user acceptance testing to ensure successful feature delivery
• Communication requirement changes and release notifications. To customers in a clear and timely manner
• Evaluate information gathered from multiple sources, resolve conflicts, break down high-level information into detailed requirements, and differentiate between user requests and underlying business needs
• Partner with customer success teams during implementations to configure the application according to customer specific needs
• Participate in go-live activities and conduct product training sessions to end users
• Work with internal risk adjustment teams to ensure timely integration of model updates (e.g., CMS, HHS, CDPS) into the product
• Collaborate with external and internal stakeholders to analyze information needs and translate them into functional deliverables such as business requirements documents, use cases, user interface(UI) mockups, screens/interfaces designs
• Work closely with with developers and subject matter experts to create product specification documents, business architecture diagrams, solution design etc.
• Apply experience in enterprise-wide requirement definitions, management tools and methodologies
• Manage multiple initiatives concurrently and ensure consistent progress across projects
• Understanding of companion guides and map requirements to internal product business rules and guidelines
• Adhere to and apply internal company policies and procedures throughout the product lifecycle

Senior Insights Analyst – Retail

Senior Software Engineer

Principal Software Engineer

Lead Software Engineer

Lead Data Scientist

Senior Data Scientist

Data Scientist

Principal AI Engineer

Senior AI Engineer

Senior Implementation Consultant

Senior Operations Engineer

Operations Engineer

Principal Software Engineer, Full Stack

Operations Engineer

Product Analyst

Data Integration Engineer, Risk Adjustment

Support Engineer

Product Analyst, Risk Adjustment