Cotiviti

Client Services Representative

• Directs the successful delivery of audit services to the client by managing the team(s) assigned to the engagement and providing leadership and direction and ensuring that the client’s needs and expectations are met and exceeded.
• Develops and implements key metrics to drive performance in quality and productivity and to ensure that the customer experience is consistent and satisfactory across all phases of the audit.
• Reviews audit progress against established metrics and direct activities as needed to ensure achievement of business goals and customer expectations.
• Ensures effective coordination with Business Optimization and other support functions to achieve audit goals.
• Continually work to improve efficiency, productivity and reduce operational costs while providing 100% compliance with customer contract and company policies.
• Supports the continuous development of innovative solutions and audit concepts with audit team.
• Effectively manages customer problems and conflict, including direct communication with customers to achieve mutually accepted resolution.
• Ensures compliance all HIPAA regulations regarding the safeguarding of Protected Health Information (PHI) and communicate to all associates involved in the audit engagement.
• Partners with the client and sales team on renewals and work through any RFP process by identifying gaps in current contract in place and understanding customer needs in order to successfully renew the contract.
• Meets regularly with audit and audit support managers to ensure appropriate staffing levels and to plan and organize workloads and staff assignments according to the needs of the audit.
• Provides managerial leadership and direct the selection, supervision, evaluation and development of staff.

Director, Audit Operations – Client Services

Architect

• Build and lead the Business Architecture capability for the Payments business unit
• Define and maintain business capabilities, value streams, ownership models, decision paths, and operating model views
• Lead analysis of business processes, handoffs, pain points, fragmentation, and decision gaps
• Design target-state operating models and business flows that support scale, efficiency, and stronger execution
• Strengthen business-to-technology translation so business priorities are reflected clearly in architecture, solution design, and delivery execution
• Partner across Business, Operations, Product, PMO, and Technology to improve alignment and reduce friction
• Identify and prioritize redesign opportunities that support automation, AI enablement, innovation, and scale
• Facilitate workshops and decision forums to align stakeholders on current-state issues, future-state design, and transformation priorities
• Establish and standardize business architecture methods, templates, and artifacts across Payments, including value stream maps, capability maps, process flows, ownership matrices, decision rights, and target-state operating model documentation
• Support executive decision-making through clear analysis, recommendations, and architecture outputs
• Build talent and team capability to understand the business deeply, challenge the status quo, and innovate
• Ensure business architecture work improves execution, reduces rework, and supports scalable change
• Hire, develop, coach, lead and retain top-tier talent, with a focus on building and improving a team and culture that is able to assist in employing best in class practices to support and drive high levels of internal and external customer satisfaction

Director, Business Architecture

Data Engineer

• Create, maintain and execute basic to intermediate Spark and SQL scripts for data management and data validation, and data integration.
• Optimize the queries to improve the efficiency of daily tasks.
• Perform data analysis and identify any issues.
• Work with other groups such as Engineering team, DBA, Cloud ops, etc. to troubleshoot and resolve any environmental or network issues that impact your work.
• Extend your support to after – hours or weekends as needed.
• Assist in the creation and maintain data pipelines as needed.
• Validates the tasks results to ensure that all the requirements are met.
• Adhere to all the industry level and organization level compliance rules and regulations to maintain data integrity.

Associate Data Engineer – Artificial Intelligence, AI

AI Engineer

• The Generative AI Developer Intern focuses on researching and developing advanced healthcare informatics, particularly in the realm of Generative AI and emerging Artificial General Intelligence.
• The intern will assist and take a primary role in developing, researching, creating analytical materials, and collaborating with various teams to drive AI-related projects.
• Gain hands-on experience in generative AI model development, architecture design, and database management.
• Communicates technology-related updates and requirements to other departments and contributes to presentations for senior management.
• Collaborates with research and development teams, product management, and strategic analysts to support ongoing projects.
• Partners with Business Units to provide reliable intelligence, validated technology options, and insights on enterprise and industry trends.
• Supports technology project teams by coordinating specific tasks, assisting with day-to-day operations, and contributing to the successful delivery of solutions.
• Completes all responsibilities and goals outlined in the internship program.
• Completes all special projects and other duties as assigned.

Intern – Generative AI Developer

Scrum Master

• Facilitating Agile ceremonies such as daily stand-ups, sprint planning, sprint reviews, and sprint retrospectives
• Coach and mentor development teams to understand and apply SAFe principles and practices
• Enable collaboration and communication within development teams and between teams and stakeholders
• Support product owners in creating and prioritizing the product backlog
• Drive continuous improvement within the organization by identifying areas of improvement
• Facilitate Scrum teams’ self-organization and high performance
• Ensure adherence to the SAFe framework and principles

Scrum Master – Retail

Software Engineer

• Build and lead a multi-team engineering organization with clear goals, outcome-based metrics, and a culture of continuous improvement
• Improve delivery throughput and resource utilization through streamlined processes, automation, and AI-enabled tools without compromising quality or maintainability
• Advance AI-enabled engineering practices by integrating AI tools and automation into workflows with human oversight and clear guardrails
• Lead roadmap execution with hands-on technical and architectural oversight to ensure scalable, secure, and maintainable solutions
• Align teams to enterprise architecture, governance, and shared engineering standards to improve consistency and code quality
• Partner across product, program, operations, and business teams to translate priorities into engineering plans that deliver measurable outcomes
• Modernize development and testing practices through automation, DevOps, and AI-enabled workflows that improve quality, security, and efficiency
• Recruit, develop, and retain strong engineering talent while building a culture of growth, accountability, and innovation

Director Engineering – AI Native

Customer Support

• Perform a variety of support and general administrative assignments in support of the audit or auditors, including filing, data entry, tracking and correspondence following established standards and work processes
• Obtains data files and/or generates reports for audits by identifying appropriate file parameters extracting data from downloaded and/or imported data files as requested by auditor
• May be required to review client systems and update Cotiviti systems accordingly
• Serves as a point of contact and facilitate responses to general inquiries and data requests from both internal and external customers
• As requested, or required, communicates directly with the client or providers following established processes and procedures
• Provides proofing support on claims submittals to double check totals, verbiage, calculations, or general accuracy prior to client submission
• Maintains productivity goals and standards set by the department
• Ensure all department rules and processes are followed
• Alerts manager of system issues or other issues impacting productivity
• Achieves the expected level of quality set by the department
• Verifies completeness and accuracy of work
• Alerts manager of issues or concerns impacting quality of work
• Ensures vendor compliance with quality standards and/or regulatory requirements established by the government or by the client organization
• Identifies sources of information and executes processes ensuring information is disseminated and updated
• Collaborates with Information Technology departments to develop knowledge-sharing technology products or solutions
• Executes all functions with a focus on accuracy and efficiency
• Maintains all regulatory guidelines including HIPAA compliance
• Demonstrates understanding of Cotiviti policies & procedures, and external regulatory requirements and performs duties in accordance with such regulatory requirements
• Assures confidentiality and security of all data, adhering to all HIPAA laws and requirements
• Demonstrates the skills, knowledge, and ability to ensure that our environment is a safe one, complying with industry standards
• Adheres to all critical operations and client specific requirements
• Performs work under direct supervision
• Handles basic issues and problems and refers more complex issues to higher-level members of the team; Senior and/or Team Lead
• Quickly adapts to learning and understanding of basic elements and concepts of audit operations
• Demonstrates enthusiasm for learning and applying knowledge to the completion of tasks
• Successfully integrates and executes new assignments with moderate guidance and direction
• Demonstrates adeptness in gathering data, analyzing problems, evaluating options, and developing/implementing creative solutions to job challenges
• Makes logical, well-reasoned and timely decisions, seeking guidance and support as appropriate
• Demonstrates competency with tools of the job including but not limited to filing systems, computers, word processing & spreadsheet applications, web systems, Cotiviti and Client systems, data file structures and Power Point
• Can efficiently download and format common file types
• Demonstrates ability to plan, organize, and prioritize multiple tasks and ensure timely completion
• Uses a structured and dependable approach to accomplishing assigned work

Yield Support Specialist

Full-stack Engineer

• Design and develop backend services and APIs using Java (Spring Boot, microservices)
• Integrate services with workflow engines (Temporal.io, Camunda, Flowable, JBPM, Drools) and platforms such as Appian
• Build and expose AI-enabled service capabilities for workflow automation and decision support
• Use AI-assisted tools (Claude, Copilot) for: code generation, testing, documentation, development acceleration
• Implement AI-native workflow patterns, including: intelligent routing, context-aware processing, embedded decision support
• Develop microservices and event-driven architectures supporting distributed workflow execution
• Collaborate with data teams for data access, validation, and transformation
• Support service orchestration and runtime workflow execution
• Contribute to CI/CD, DevSecOps, and cloud-native deployments: OpenShift / Kubernetes / AWS
• Participate in code reviews, design discussions, and cross-team collaboration.

Senior Software Engineer, AI

Backend Engineer

• Lead design and development of Java-based backend services (Spring Boot, microservices)
• Implement solutions across workflow platforms (Temporal, Camunda, Flowable, JBPM, Drools, Appian)
• Build AI-enabled service capabilities for workflow automation and decision support
• Drive adoption of AI-assisted development (Claude, Copilot) with strong validation and engineering standards
• Implement AI-native patterns : intelligent routing context-aware processing embedded decision support
• Lead microservices and event-driven architectures for scalable systems
• Collaborate with architects to translate design into implementation
• Provide technical leadership: design/code reviews mentoring engineers guiding best practices
• Support CI/CD, DevSecOps, and cloud deployments (OpenShift, Kubernetes, AWS)
• Drive reusable services and shared platform components

Staff Engineer I, AI, Java

Product Manager

• Champion the entire product lifecycle from visionary feature ideation to successful launch.
• Work with engineering teams to translate product requirements into technical specifications, features, and actionable tasks.
• Develop and articulate a clear product vision and roadmap.
• Create and maintain a feature backlog, prioritizing features based on value, impact, and technical feasibility.
• Work collaboratively within cross-functional teams including business operations, engineering, architecture, and design.
• Cultivate and nurture collaborative relationships with internal stakeholders.
• Make data-driven decisions based on customer feedback, and business insights to prioritize features, allocate resources, and mitigate risks.
• Coordinate the successful launch of new platforms and features, including all required training and support during the implementation phase.
• Establish key performance indicators (KPIs) and metrics to measure the success of products post-launch and iterate based on data-driven insights.

Platform Product Manager

Lead Generation

• Provide deep expertise in molecular diagnostics (germline and somatic), next-generation sequencing (NGS) and multigene panels, and laboratory billing practices (CPT/HCPCS, PLA codes, stacking)
• Act as the primary clinical partner to CST analysts to translate clinical intent into prepay-editable rule logic
• Lead or co-lead development of Coding Validation (CV) edits, and postpay data-mining concepts across laboratory and genetic testing
• Present rule logic and strategy to payer clients; translate complex genetic testing concepts into clear clinical narratives and financial impact/savings opportunity

Lead Genetic Testing and Laboratory SME

Data Scientist

• Build and evaluate classification or regression models using Python and standard ML libraries
• Engineer features from claims, clinical, or operational datasets
• Clean, transform, and profile datasets; document data-quality findings and assumptions
• Write SQL against relational databases to extract and shape analytical inputs
• Build lightweight APIs or endpoints to surface model outputs (e.g., FastAPI)
• Contribute to version-controlled, reproducible workflows using Git
• Document pipelines so teammates can extend and audit your work
• Assist with experiments at the intersection of ML and healthcare workflows

Temporary Intern, Data Scientist

Content Marketing Manager

• Provide coding and industry expertise to help create and maintain clinical coding edits
• Assist with research to identify opportunities for new medical policies
• Reviews and identifies changes to medical policies to maintain accurate library
• Work with QA to create and execute test cases to validate policy changes
• Provide coding and clinical expertise for customer inquiries or appeals
• Create and maintain documentation for Cotiviti’s medical policy library
• Maintain current knowledge-base of industry and Cotiviti content
• Complete all responsibilities as outlined on annual Performance Plan
• Complete all special projects and other duties as assigned

Content Analyst I

Technical Product Manager

• Conduct interviews and requirement workshops with a cross-disciplined team to elicit an understanding of business needs.
• Collaborate with key stakeholders and the development team to drive a solution that meets the program-level objectives and vision.
• Document and maintain requirements (features and user stories) via collaboration with the product, business, and development teams.
• Refinement of program backlog and preparation/readiness for Program Increment Planning.
• Prioritize and maintain the team backlog in coordination with the Scrum Master and Delivery Lead.
• Acceptance of user stories completed at the end of each iteration/sprint.
• Complete all responsibilities as outlined in the annual performance review and/or goal setting.
• Complete all special projects and other duties as assigned.

Technical Product Owner

Auditor

• Assess job-specific needs and develop technical training plans with clear business objectives
• Select training/instructional methods and procedures appropriate for the situation
• Deliver specific training sessions, including using suitable delivery methods such as classroom, online, and webinar
• Identify the development needs of others and coach, mentor, or otherwise assist others with improving their knowledge skills
• Provide support to the CCV audit team members; assist with orientation of new members as needed
• Promote audit accuracy measures by training/educating and mentoring the auditor and providing documented and validated findings
• Conduct or arrange for ongoing technical training and personal development classes for staff members
• Integrate healthcare auditing principles and use objectivity in the performance of medical audit activities and reviews
• Provide feedback on reviews to the Quality Assurance Manager as indicated