C

Cotiviti

Catches billing errors for health insurers

Data Governance and Analytics Architecture Director

Full-TimeDeadline 8/27/27
$150k - $200k/yr+ Discretionary bonus
Expert
Bachelor's
Remote in USA
Remote
Data & AnalyticsData Management

About the job

Requirements
  • An advanced degree in Computer Science, Engineering, Data Science, or a related field is required.
  • At least 10 years of experience in data governance, data architecture, data engineering, and analytics roles is required.
  • At least 5 years of leadership experience driving enterprise-scale data governance, data architecture, and analytics platform initiatives is required.
  • Proven ability to define and implement data governance frameworks, standards, and data quality processes.
  • Strong expertise in data modeling, data warehousing and lakehouse architectures, cloud-based analytics platforms, and modern data ecosystems.
  • Experience enabling analytics and artificial intelligence/machine learning solutions to scale from prototype to production deployment.
  • Strong understanding of business intelligence platforms, extract, transform, and load/extract, load, and transform frameworks, and data lifecycle management.
  • Experience working across analytics, product, engineering, and innovation teams in complex environments.
  • Ability to translate business and analytics priorities into scalable technical architecture and design.
  • Strong leadership, stakeholder management, and decision-making capabilities.
  • Ability to work independently in a fast-paced environment as part of a distributed team, with effective communication and collaboration skills.
  • Ability to handle stressful situations and multiple tasks while meeting deadlines.
  • Ability to communicate clearly, concisely, and professionally at all levels within the organization.
  • Demonstrated teamwork, leadership, and project management discipline.
  • Demonstrated ability to work cross-functionally to drive business outcomes.
  • Ability to communicate with others to exchange information.
  • Ability to assess the accuracy, neatness, and thoroughness of assigned work.
  • Critical-thinking and problem-solving ability, with strong analytical modeling and technical skills.
  • Ability to provide high-speed internet connectivity and maintain an office setup.
  • Ability to provide a dedicated, secure work area.
  • Ability to perform duties with or without reasonable accommodation.
  • Ability to remain stationary, often standing or sitting for prolonged periods, and perform repetitive motions involving the wrists, hands, or fingers.
Responsibilities
  • Contribute to the development of data governance standards and best practices across analytics and reporting.
  • Provide guidance on data quality, consistency, and appropriate use of enterprise data assets.
  • Support standardization of data models, business metrics, and reusable data assets to improve consistency and efficiency.
  • Implement governance frameworks and embed policies into day-to-day data and analytics workflows.
  • Establish clear data stewardship accountability across business and analytics teams.
  • Oversee data quality processes, metadata management, and governance monitoring to sustain data integrity.
  • Serve as the primary point of contact for Information Governance, data risk, and compliance alignment.
  • Drive standardization of data assets to reduce fragmentation and enable consistent cross-domain insights.
  • Provide subject matter expertise on analytics architecture across business intelligence, reporting, and advanced analytics.
  • Partner with teams to align solutions with enterprise data platforms and long-term strategy.
  • Recommend architectural approaches that support scalability, interoperability, and reuse.
  • Serve as a technical subject matter expert contributing to artificial intelligence and machine learning standards and best practices.
  • Provide guidance to ensure analytic and artificial intelligence solutions are designed for scalability and sustainability.
  • Advise on approaches to monitor performance, manage technical debt, and identify architectural risk.
  • Assess the technical feasibility of innovation and analytics initiatives and provide input on viable solution approaches.
  • Consult on solution design to support production readiness and scalability.
  • Identify constraints in data or architecture and propose practical workarounds to enable business outcomes.
  • Define guardrails that enable faster decision-making and reduce execution friction.
  • Serve as a consultative technical partner to Innovation, Data Science, Reporting, and broader enterprise teams.
  • Translate business and analytics requirements into technical solutions and executable designs.
  • Provide input on feasibility, architecture, and standards to support solution development.
  • Collaborate across teams to align analytics solutions with enterprise direction while meeting business needs.
  • Contribute technical expertise to vendor evaluations and platform decisions as needed.
  • Hire, develop, coach, lead, and retain talent while building and improving a team and culture that supports best practices and customer satisfaction.
  • Complete responsibilities outlined in annual performance reviews and goal setting.
  • Complete special projects and other assigned duties.
Desired Qualifications
  • Enterprise project management methods and process management experience.

About the company

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, Utah

Founded

1979

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Simplify's Take

What believers are saying

  • Its results are measurable: in July 2026, Cotiviti reported catching over $10 billion in claim payment errors during 2025.
  • Every employee shares in ownership: Prosperiti, a plan backed by owner KKR, has covered all 9,000-plus staff since September 2024.
  • Room to build AI skills: 20 of Cotiviti's 82 US openings in October 2026 were AI jobs, including three internships.

What critics are saying

  • Expect new bosses: Cotiviti replaced its CEO of 10 years in March 2026 and named a new COO in September.
  • Debt is heavy: a $5 billion bank loan helped fund KKR's 2024 deal valuing Cotiviti at about $11 billion.
  • An AI rival is bulking up: Machinify bought Medicare auditor Performant for $670 million in October 2025.

What makes Cotiviti unique

  • Medicare relies on it: Cotiviti holds three of the five regional contracts to audit paid Medicare claims.
  • Every major insurer is a client: Cotiviti works with all 25 of the largest US health plans.
  • Remote work is the norm: 81 of 82 US openings on Cotiviti's careers site in October 2026 were remote.

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Benefits

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

401(k) Retirement Plan

Paid Vacation

Paid Holidays

Remote Work Options

Company News

Yahoo Finance
Sep 14th, 2026
Cotiviti appoints Erin Schmuker as chief operating officer to scale operations

Cotiviti has appointed Erin Schmuker as chief operating officer. Schmuker will report to president and chief executive officer Ric Sinclair and join the executive leadership team. Schmuker brings over 20 years of healthcare leadership experience. She joins from Optum, where she most recently served as president of Integrated Pharmacies at OptumRx. Previously, she was managing director of Optum Ireland and UK. As chief operating officer, Schmuker will lead Cotiviti's enterprise operations, focusing on scaling the company's operating model and strengthening execution. She will work to simplify operations and help translate investments in technology and AI into measurable outcomes for clients. Cotiviti describes itself as "The Healthcare Infrastructure Company" and connects data, intelligence, and workflows in the US healthcare system.

Associated Press
Aug 13th, 2026
Cotiviti launches AI-enabled Proactive COB to resolve health insurance coordination at enrollment

Cotiviti has launched Proactive COB, a coordination of benefits capability that uses AI to identify health insurance coverage issues at member enrolment, before claims are submitted. The solution analyses enrollment and maintenance transactions to detect coverage discrepancies early, allowing health plans to prevent payment errors rather than recover overpayments after the fact. Traditional COB approaches rely on retrospective discovery methods, often missing errors until after claims are paid. Proactive COB combines AI-driven prioritisation with validated member databases and over 25 years of COB experience to maintain accurate coverage records throughout the benefit lifecycle. The capability operates on enrollment data and supports automated updates to eligibility platforms, reducing manual intervention whilst maintaining audit trails. Cotiviti's platform serves customers covering over 300 million members and patients in the US.

Yahoo Finance
Aug 4th, 2026
Cotiviti launches AI-powered dental claim accuracy solution amid $198B annual dental spending

Cotiviti has launched an enhanced Dental Claim Accuracy solution on its Payment Policy Management platform to help healthcare and dental payers improve claim processing. The URAC-accredited solution unifies dental and medical payment workflows on a single platform, supporting both batch and real-time processing. The new offering features AI-assisted rule authoring, clinical validation by licensed dentists, and enhanced fraud detection capabilities. It integrates with Cotiviti's Payment Clarity platform to provide explanations of claim decisions and executive reporting. Matthew Hawley, Executive Vice President of Payment Integrity for Cotiviti, noted that dental spending has reached an estimated $198 billion per year. The solution aims to address challenges including fraud, waste, abuse, overtreatment, and miscoding that contribute to improper payments and increased administrative burden for payers.

Yahoo Finance
Apr 24th, 2026
Cotiviti appoints John Hallock as chief corporate affairs officer to lead next growth phase

Cotiviti, a healthcare software and data-driven technology company, has appointed John Hallock as Chief Corporate Affairs Officer. Reporting to CEO Ric Sinclair, Hallock will oversee corporate communications, brand development, marketing strategy and investor relations. The appointment comes as Cotiviti expands beyond healthcare enterprise solutions into a system-level platform operating across the healthcare ecosystem. The company aims to establish a structural utility layer governing financial accuracy and decision-making whilst reducing administrative waste and costs. Hallock brings over 20 years of experience building category-defining companies. He previously led communications and investor positioning for Livongo's IPO and athenahealth's IPO. Most recently, he served on the founding leadership team at Smarter Technologies, helping shape the company's creation, platform build and strategic acquisitions.

Yahoo Finance
Apr 16th, 2026
Cotiviti showcases AI-enabled provider risk adjustment solutions at US healthcare conferences

Cotiviti, a healthcare software and data technology company, is presenting at the ACDIS Conference in Chicago (19–23 April) and NAACOS Spring Conference in Baltimore (22–24 April). The company is showcasing its AI-enabled risk adjustment solutions designed to improve coding workflows and patient outcomes for health systems and accountable care organisations. Cotiviti's expanded provider portfolio combines its clinical expertise with Edifecs' risk adjustment technology, offering capabilities including member suspecting, pre-visit preparation, post-visit review and retrospective coding reviews. The HITRUST-certified solutions aim to improve operational efficiency whilst reducing the need for cost-intensive clinical team reviews. At ACDIS, Cotiviti's Betty Stump will present on navigating risk adjustment challenges and HCC coding standards. Cotiviti's services support over 300 million healthcare consumers across the US.