Technical Specialist – Healthcare

This is a fully remote position, open to applicants in United States.

📋 Description

• Collaborate with the RCA - Content & Enablement Department, Implementations Team, and Audit Operations and R&D teams.

• Gather business rules from various internal Cotiviti teams.

• Work alongside internal partners to clarify the intent behind each rule.

• Design and develop rule logic for integration into the Business Rules Management System (BRMS).

• Conduct deployment and testing of rules in a test environment to ensure accuracy.

• Implement rules into production environments.

• Communicate with operations and key stakeholders post-production deployment.

• Maintain and update documentation associated with each rule.

• Generate impact reports and analyses.

• Utilize tools and technology to track and report on requests.

• Collaborate with teams throughout the organization to address end user needs.

• Serve as a liaison between the operations team and the BRMS Center of Excellence.

⛳️ Requirements

• High School Diploma is required.

• A Bachelor’s degree in education, technical writing, communications, or related fields is strongly preferred.

• Equivalent experience may be accepted in place of a degree.

• A minimum of 3-4 years of Cotiviti experience or equivalent experience in the healthcare industry.

• Basic coding skills; must understand fundamental programming languages and possess the ability to write and comprehend code in SQL, Java, or similar languages.

• Familiarity with Access, HUE, Datameer, Power BI, or SQL Server Management Studio (SSMS).

• Understanding of complex business rules and products such as DROOLS in RedHat Decision Manager.

• Experience in analyzing large datasets and auditing payment discrepancies.

• Ability to work independently and effectively communicate and collaborate with others.

• Strong analytical and problem-solving skills.

• Capability to manage multiple assignments concurrently while adhering to deadlines and quality standards.

• Excellent organizational, communication, and presentation skills.

• Flexibility to work different shifts as necessary.

• Proficient in Microsoft Word, Excel, PowerPoint, Visio, and Outlook.

• Must be able to provide a dedicated and secure work area.

• Must ensure high-speed internet access/connectivity and maintain an office setup.

• At least 1 year of Cotiviti experience is recommended for individuals looking for internal advancement.

🏝️ Benefits

• Discretionary bonus consideration.

• Medical insurance coverage.

• Dental insurance coverage.

• Vision insurance coverage.

• Disability insurance coverage.

• 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, based on specific level and length of service with Cotiviti.

• Dedicated, secure work area.

• High-speed internet access/connectivity and office setup and maintenance.