Director Quality (Payment Integrity)

Responsibilities

• Oversee and drive quality performance across payment integrity solutions, ensuring continuous improvement and operational excellence.
• Collaborate with cross-functional business units to measure, report, and enhance quality performance metrics and outcomes.
• Develop and align best-in-class quality processes and standards, delivering exceptional results through operational excellence.
• Work closely with Operations and Product teams to drive quality improvements by leveraging technology, optimizing processes, and developing talent.
• Ensure timely and accurate responses for Payment Requests for Information (RFIs) and Request for Proposals (RFPs).
• Support client intake requests for Pre-Payment Business Unit by understanding client requirements and providing tailored solutions and cost estimates.
• Hire, develop, coach, and retain top-tier talent, fostering a culture dedicated to exceptional quality and customer satisfaction.
• Optimize labor and operating expenses while increasing productivity, service quality, and supporting future client growth.
• Lead and support operational improvement initiatives encompassing people, processes, and technology to deliver incremental value and operational efficiency, consistently meeting or exceeding service and quality goals.
• Enforce Cotiviti’s intellectual property protection best practices throughout all operations.
• Diagnose and resolve issues proactively, manage schedules, and ensure deadlines are met for timely completion of work.
• Develop short-term and long-term plans to anticipate client needs and operational improvements.
• Cultivate a positive workplace culture that supports corporate goals, promotes initiative, and fosters open communication at all organizational levels.
• Collaborate and support business leaders throughout the organization, maintaining highly effective client and team dynamics in a collaborative environment.
• Manage and delegate team and individual projects/assignments, and review performance against operating plans and standards.
• Provide comprehensive reports and metrics to drive operational quality and inform strategic decisions, based on operational objectives and work plans at a senior level.
• Build, maintain and influence strong relationships with executive leadership to support organizational goals.
• Hire, develop, coach, lead and retain top-tier talent, with a focus on building and improving a team and culture that is able to assist in employing best in class practices to support and drive high levels of internal and external customer satisfaction.

Qualifications

• Bachelor’s degree in business, operations, healthcare or equivalent in a related field required and Master’s preferred.
• Minimum of five years’ management experience, ideally within the healthcare industry.
• Demonstrated operational excellence, exceptional problem-solving ability, and proven people leadership skills.
• Expertise in collaborating with key stakeholders and executive decision-makers.
• Established leadership in directing operational divisions, shaping policies, practices, and achieving division objectives.
• Highly developed interpersonal, analytical, and communication skills.
• Proven track record of driving business improvement initiatives and delivering measurable outcomes.
• Deep process-oriented expertise, with a focus on simplifying and scaling operations while maintaining superior quality.
• Advanced technological proficiency, including experience in software development and payment integrity solutions.
• Significant experience presenting to clients and senior leadership.
• Skilled in responding to client requests for information, audits, and proposals.
• Exceptional performance management skills demonstrated through outstanding team and organizational outcomes.
• Able to excel within fast-paced, highly accountable, and diverse environments, maintaining a strong client and customer service focus.
• Extensive experience in strategic planning and operational development.
• Renowned leadership qualities coupled with a history of successfully managing and developing high-performing teams.
• Superior analytical and problem-solving capabilities, with a talent for diagnosing and resolving operational inefficiencies.
• Excellent written and verbal communication skills, including public speaking experience.
• Proficient in Microsoft Office Suite (Word, Excel, PowerPoint).
• Professional integrity, with experience in appropriately handling confidential information.
• Capable of working independently or collaboratively, effectively managing multiple priorities and meeting deadlines.
• Experience operating in matrixed organizational structures.
• Demonstrated ability to effectively manage stressful situations, including high volumes and frequent change.
• Willingness to travel as business needs require.
• Demonstrated ability to effectively manage stressful situations, including high volumes and frequent change.
• Value-Adding Certifications: Lean Six Sigma (Green Belt, Black Belt, or Master Black Belt), Certified Quality Auditor (CQA) or Certified Manager of Quality/Organizational Excellence (CMQ/OE), Project Management Professional (PMP), Certified Professional in Healthcare Quality (CPHQ), Certified Payments Professional (CPP).

Pay

Base compensation ranges from $140,000 to $185,000 per year. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs.

Schedule

This role is eligible for discretionary bonus consideration.

Benefits

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.

Date of Posting

5/3/2026