C

Cotiviti

Catches billing errors for health insurers

Vice President Product Interoperability

Technical Product ManagementConfirmed live in the last 24 hours
Full-timeRemote in USA

About the Job

Requirements

  • A bachelor's degree in business, computer science, information technology, or equivalent professional experience is required.
  • 10 to 15+ years of progressive insurance and product experience, including at least eight years in senior leadership roles overseeing matrixed teams.
  • 10+ years of experience with increasing responsibility and oversight managing Product, Operations, or Professional Services.
  • 10+ years of healthcare industry experience is preferred, together with domain leadership experience, personnel management and presentation skills, and customer problem-diagnostics and solution-design capabilities.
  • Deep subject matter expertise in payer/provider interoperability and claims-processing operations is required; direct experience managing claims operations or payer/provider interoperability for a health plan is strongly preferred.
  • Deep knowledge of interoperability standards, the regulatory environment, and compliance considerations is required; the ability to measure and articulate the business value of compliance is preferred.
  • Advanced knowledge of claims-management ecosystems and the ability to align R&D processes such as SAFe Agile with core operational needs.
  • Proven strategic and tactical leadership experience and the ability to pursue and understand emerging technologies.
  • Experience in growth-oriented healthcare information and analytics businesses, including competencies in product development and strategy.
  • Ability to solve problems and think critically, complete tasks independently, make timely workflow decisions, maintain focus, and assess work for accuracy, neatness, and thoroughness.
  • Ability to remain stationary, often standing or sitting for prolonged periods, and perform repetitive motions involving the wrists, hands, and/or fingers.
  • Ability to provide a dedicated, secure work area and high-speed internet access/connectivity, and to set up and maintain an office.

Responsibilities

  • Own and execute Cotiviti’s market strategy, product roadmap, and commercial growth for health plan interoperability, expanding payer/provider collaboration.
  • Prioritize market needs, conduct competitive analysis, engage internal and external experts, and lead product launches that expand client value and advance market position.
  • Own product vision, definition, packaging, and market success across the interoperability platform and commercial solutions.
  • Lead a matrixed, multi-level team in enhancing existing solutions and delivering next-generation payer/provider collaboration solutions.
  • Ensure product offerings are FHIR-native and leverage the Interoperability Platform.
  • Provide subject-matter expertise and input into Cotiviti’s strategic plan across business units.
  • Collaborate with executive leadership to develop annual bookings, revenue, expense, and client-satisfaction targets.
  • Represent the voice of the customer in product management and development.
  • Develop multi-year roadmaps for payer/provider collaboration, spanning provider workflows through post-adjudication.
  • Provide executive leadership for the interoperability business, including product, market, and operational strategy; revenue growth; client outcomes; and long-term expansion.
  • Develop and influence corporate strategy relating to interoperability, provider connectivity, healthcare data exchange, and payer/provider collaboration.
  • Represent Cotiviti with key clients, strategic partners, regulators, industry consortiums, and market influencers.
  • Apply insight into payer platforms, processes, administrative inefficiency, and payer/provider interoperability.
  • Drive process re-engineering using AI and emerging technologies.
  • Apply payer-cost-management knowledge to identify administrative waste in claims processing, prior authorization, and other operational processes using advanced data analytics tools; assess areas of strength and gaps.
  • Own business performance, revenue growth, operating-margin achievement, investment prioritization, and long-range financial planning for the interoperability business.
  • Ensure products and operational workflows adhere to state and federal regulations.
  • Lead a multidisciplinary organization through directors, senior directors, and other senior leaders responsible for Product Management, Product Operations, Market Strategy, and Product Commercialization.
  • Lead cross-functional Product, Marketing, Sales, Business Unit Operations, and R&D teams to develop and launch solution enhancements.
  • Align with Business Unit and R&D processes, including SAFe Agile, and with Product Management teams delivering capabilities.
  • Define success criteria, review product performance, and facilitate or influence portfolio changes to improve competitive position and optimize performance.
  • Own the definition of the end-to-end customer experience.
  • Lead the completion and upkeep of Ready to Market and Ready to Sell tools, content, and training.
  • Collaborate with Product leadership to establish and continuously improve Product Management processes.
  • Assist Business Unit leaders in defining core processes and staffing needs for new solutions.
  • Champion product development and product management practices, ensuring teams have the tools, processes, and skills to build roadmaps aligned with strategic and operational plans.
  • Define and execute three-to-five-year growth strategies, including market expansion, partnerships, acquisition integration opportunities, and innovation investments.
  • Develop solutions that support profitability, efficiency, and growth targets.
  • Lead others in designing and developing new products.
  • Understand client needs by asking effective questions and engaging others to solve challenges; assist in developing pricing strategies to maximize returns.
  • Work with technology, operations, and senior leadership to ensure high-quality releases and demonstrate progress against quality goals through clear metrics.
  • Hire, develop, coach, lead, and retain talent, building and improving a team and culture that supports high levels of internal and external customer satisfaction.
  • Complete responsibilities outlined in annual performance reviews or goal-setting processes, special projects, and other assigned duties.
  • Perform duties with or without reasonable accommodation.

Desired Qualifications

  • A Master of Business Administration degree is preferred.
  • Direct experience managing claims operations or payer/provider interoperability for a health plan is strongly preferred.
  • The ability to measure and articulate the business value of compliance is preferred.
  • 10+ years of healthcare industry experience is preferred.

About the Company

Cotiviti

Catches billing errors for health insurers

Cotiviti sells software and review services that help US health insurers pay medical claims correctly, catch fraud, and track the quality of care their members receive. Its software for HEDIS, the care-quality scores US health plans report, has passed certification by the nonprofit NCQA every year since 2001. Insurers run claims through its coding and payment-policy checks before paying them, while its auditors review medical records and paid claims to recover overpayments. Clients pay it software fees or a share of the savings it finds. Cotiviti began in 1979 by auditing retailers' payments to suppliers, which it still does, and it is based in South Jordan, Utah, and owned by private equity firms Veritas Capital and KKR.

Company size
5,001-10,000
Company stage
IPO
Headquarters
South Jordan, UT
Founded
1979

Recently Posted Jobs

Explore more opportunities at Cotiviti

See more jobs