[Hiring] Senior Technical Specialist @Cotiviti

Role Description

The Senior Technical Specialist will collaborate closely with the RCA - Content & Enablement Department, the Implementations Team, and the Audit Operations and R&D teams. This role is responsible for the intake, logic development, deployment, and maintenance of Business Rules that support RCA’s platform applications. The Specialist will also lead efforts to identify and remediate technical limitations, design advanced exclusions logic, and support operational scalability through strategic rule development.

In addition to driving rule implementation, the Senior Technical Specialist will act as a key liaison between the operations team and the BRMS Center of Excellence—ensuring strong alignment with end-user needs—and will maintain comprehensive documentation, impact analysis, and reporting for all rule activity. This role supports continuous improvement by conducting root cause and gap analyses to identify where rules are not producing the intended outcomes, and by developing data-driven solutions to optimize performance.

Qualifications

• High School Diploma Required.
• Bachelor’s degree in education, technical writing, communications, or related fields strongly preferred. Equivalent experience may be considered in lieu of a degree.
• Experience in healthcare industry.
• Basic Coding Skills: Understanding of basic programming languages and ability to write and understand code in SQL, Java, or other.
• Familiarity with tools such as Access, HUE, Datameer, Power BI, or SQL Server Management Studio (SSMS).
• Experience with complex business rules: Familiarity with products like DROOLS in RedHat Decision Manager.
• Experience in analyzing large datasets and auditing payment inaccuracies.
• Ability to work independently, but also to communicate and collaborate with others to meet desired outcomes.
• Excellent analytical and problem-solving skills and ability to manage multiple assignments simultaneously while meeting deadlines and quality standards.
• Excellent organization, communication, and presentation skills.
• Flexible and able to work in different shifts as per the work requirement.
• Strong working experience with Microsoft suite of applications (Word, Excel, PowerPoint, Visio, Outlook).

Requirements

• Troubleshooting: The ability to diagnose and solve complex technical issues, often under pressure.
• Critical Thinking: Specialists are expected to assess a situation, evaluate possible solutions, and make decisions based on logic and data analysis.
• 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.
• Systems Thinking: Understanding how different components of a system interact with each other.
• Pattern Recognition: Identifying patterns in complex data or recurring problems to develop effective solutions.
• Prioritization: The ability to determine which technical issues are the most pressing and need immediate attention.
• Empathy and Patience: The ability to listen carefully, understand concerns, and provide solutions in a considerate manner.
• Clear Explanations: A mindset of simplifying complex technical issues and presenting them in an understandable way.

Benefits

• Base compensation ranges from $85,000 to $105,000 per year.
• This role is eligible for discretionary bonus consideration.
• Cotiviti offers a competitive benefits package including medical, dental, vision, disability, and 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, depending on specific level and length of service with Cotiviti.