Senior Technical Specialist – Healthcare

Cotiviti

Senior Technical Specialist developing and maintaining healthcare business rules for Cotiviti’s audit platform. Testing deployments, analyzing payment accuracy, and improving rule effectiveness and automation.

Posted 8/13/2026full-timeRemote • 🇺🇸 United StatesSenior💰 $85,000 - $105,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in designing and developing business rules for integration into Business Rules Management Systems, with strong analytical skills for auditing and improving rule effectiveness. Proficient in SQL and familiar with healthcare industry standards and technologies.

Highest-signal resume keywords

Business Rules Management System (BRMS)SQL ProgrammingData AnalysisHealthcare Industry ExperienceRule Effectiveness Improvement

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

SQLJavaData AnalysisBusiness Rules DesignImpact AnalysisRoot Cause AnalysisTechnical Issue DiagnosisAutomation ToolsComplex Business RulesPerformance Constraints Remediation

Soft Skills

Analytical SkillsProblem-Solving SkillsCommunication SkillsOrganizational SkillsCollaboration Skills

Tools & Technologies

Power AutomateJIRAAsanaPower BISQL Server Management Studio (SSMS)AccessHUEDatameerMicrosoft WordMicrosoft Excel

Industry Keywords

Healthcare IndustryBusiness RulesAudit OutcomesTechnical LimitationsOperational Results

Tech Stack

Tools & technologies

JavaSQL

About the role

Key responsibilities & impact

Receive business rules from various internal Cotiviti teams
Collaborate with internal partners to clarify rule intent and context
Design and develop rule logic for integration into the Business Rules Management System (BRMS)
Test and validate rules in non-production environments
Implement validated rules into production environments
Communicate rule deployment outcomes and changes to operations and stakeholders
Maintain documentation and version history for business rules
Perform impact analysis for new or revised rules
Conduct root cause analysis and identify gaps in audit or operational results
Recommend and implement corrective actions to improve rule effectiveness
Identify and remediate technical limitations and performance constraints
Lead design and integration of additional exclusions functionality
Partner with operations teams to socialize rules and gather user feedback
Develop reporting and insights on rule effectiveness, audit outcomes, and content trends
Explore automation and workflow enhancements using tools such as Power Automate, JIRA, and Asana
Identify opportunities to transition support, training, or documentation tasks to downstream teams
Complete annual Performance Plan responsibilities and assigned special projects

Requirements

What you’ll need

High School Diploma required
Bachelor’s degree in education, technical writing, communications, or related fields strongly preferred
Equivalent experience may be considered in lieu of a degree
Experience in the healthcare industry
Basic coding skills and ability to write and understand SQL, Java, or other programming languages
Familiarity with Access, HUE, Datameer, Power BI, or SQL Server Management Studio (SSMS)
Familiarity with complex business rules and products such as DROOLS in RedHat Decision Manager
Experience analyzing large datasets and auditing payment inaccuracies
Ability to work independently and collaborate with others
Excellent analytical and problem-solving skills
Ability to manage multiple assignments while meeting deadlines and quality standards
Excellent organization, communication, and presentation skills
Flexibility to work different shifts as required
Strong working experience with Microsoft Word, Excel, PowerPoint, Visio, and Outlook
Ability to diagnose and solve complex technical issues
Critical-thinking and complex-analysis abilities
Industry-specific knowledge of relevant technologies, systems, or products
Systems-thinking and pattern-recognition abilities
Ability to prioritize technical issues
Empathy, patience, and ability to provide clear explanations when interacting with customers or users
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
Must be able to perform duties with or without reasonable accommodation

Benefits

Comp & perks

Discretionary bonus consideration
Medical insurance
Dental insurance
Vision insurance
Disability insurance
Life insurance
401(k) savings plan
Paid family leave
9 paid holidays per year
17–27 days of Paid Time Off (PTO) per year, depending on level and length of service
Remote work arrangement
Dedicated, secure work area and office setup support requirements