Senior Technical Specialist (Healthcare)

Cotiviti's Operational Insights team is seeking a highly motivated and experienced Senior Technical Specialist to support strategic data and analytics initiatives that inform healthcare performance improvement. This role will focus on helping to structure, organize, and maintain data content supporting audit results, while enabling scalable insights that assist both internal and external benchmarking. You'll work across departments to ensure consistency in content, delivery, and insight development within Cotiviti's enterprise data ecosystem. This is a key technical role supporting a team of analysts, auditors, and healthcare professionals in delivering claims-related analytics that drive meaningful outcomes.

Content Organization and Management: Support the development and governance of structured content that houses analytic methods, measurement approaches, and audit result frameworks. Collaborate with content leads and enablement teams to ensure content is curated, up to date, and aligned to Cotiviti's broader strategic objectives.
• Opportunity Analysis and Insight Development: Collaborate with internal teams to process audit-derived findings and support the interpretation and summarization of those results. Work to align findings with enterprise benchmarking strategies that allow health plans to compare performance across similar populations or audit types.
• Insight Consumption and Reporting: Assist in transforming structured data into meaningful performance insights through dashboards, standard templates, and comparative summaries. Coordinate with insight leads to ensure delivery of clear, accurate metrics that resonate with both technical and non-technical stakeholders.
• Scalable Benchmarking Support: Help enable standardized benchmarking capabilities by contributing to shared frameworks, methods, and measurement libraries that support RCA findings and client-facing analytics.

Required:

• High School diploma or equivalent.
• Bachelor's degree in a related field (e.g., Computer Science, Data Analytics, Healthcare Informatics) preferred - or equivalent work experience.
• Minimum of 5 years' experience leading cross-functional, project-focused initiatives.
• Prior experience in the healthcare industry, especially with medical claims workflows (billing, adjudication, auditing).
• Proficiency in IT applications, data processing, and integration (MS Office Suite required).
• Demonstrated ability to develop, implement, and maintain project plans (task breakdown, work assignments).
• Exceptional presentation skills: able to speak and present with authority to stakeholders, adapt to changing priorities, and thrive in a fast-paced environment.
• Highly autonomous and solution-oriented, with a strong customer-service ethic.

Preferred:

• At least 1 year of prior Cotiviti experience.
• Hands-on experience with Spark, Python, and SQL for data engineering.
• Familiarity with Kusto Query Language (KQL) for ad-hoc analytics.
• Experience designing multi-stage (bronze/silver/gold) data pipelines.
• Background in statistical extrapolation methods and confidence-interval analysis for audit findings.
• Exposure to Microsoft Fabric components (Lakehouses, Warehouses, Data Pipelines, Notebooks).
• Healthcare audit analytics expertise: interpreting audit results for operational and financial reporting.
• Knowledge of data-security and governance best practices for PHI/PII.
• Experience with Scaled Agile frameworks and matrixed team environments.

Mental Requirements:

• Troubleshooting: The ability to diagnose and solve complex technical issues, often under pressure. Technical Specialists must quickly identify the root cause of problems and find effective solutions.
• Critical Thinking: Specialists are expected to assess a situation, evaluate possible solutions, and make decisions based on logic and data analysis, rather than assumptions or intuition.
• Complex Analysis: Some technical problems require the specialist to break down complicated systems or data into manageable parts to analyze and understand them.
• Industry-Specific Knowledge: A deep understanding of the specific technologies, systems, or products relevant to the role. This could range from IT systems and programming languages to mechanical engineering or network architecture.
• Systems Thinking: Understanding how different components of a system interact with each other and being able to foresee how changes to one part of the system may affect others.
• Pattern Recognition: Identifying patterns in complex data or recurring problems to develop effective solutions, both in day-to-day tasks and long-term projects.
• Prioritization: The ability to determine which technical issues are the most pressing and need immediate attention versus those that can be addressed later, often in high-pressure environments.
• Empathy and Patience: In cases where the technical specialist interacts directly with customers, the ability to listen carefully, understand concerns, and provide solutions in a way that's considerate of the customer's needs is important.
• Clear Explanations: A mindset of simplifying complex technical issues and presenting them in a way that the customer or user can understand.

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.

Base compensation ranges from $84,000 to $105,000 per year. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs. This role is eligible for discretionary bonus consideration.

Cotiviti offers team members a 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, and 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti. For information about our benefits package, please refer to our Careers page.

Date of posting: 5/8/2025

Applications are assessed on a rolling basis. We anticipate that the application window will close on 6/8/2025, but the application window may change depending on the volume of applications received or close immediately if a qualified candidate is selected.

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