Technical Specialist (Healthcare)

Responsibilities

• Receive business rules from various internal Cotiviti teams.
• Collaborate with internal partners to clarify the intent of each rule.
• Design and develop rule logic for integration into the Business Rules Management System (BRMS).
• Conduct deployment and testing of rules in a test environment to verify accuracy.
• Implement rules into production environments.
• Communicate effectively with operations and key stakeholders following production deployment.
• Maintain and update documentation associated with each rule.
• Produce impact reports and analyses.
• Use tools and technology to track and report on requests.
• Partner with teams across the organization to support end user needs.

Qualifications

• High School Diploma Required.
• Bachelor’s degree in education, technical writing, communications, or related fields strongly preferred.
• Minimum 3-4 years Cotiviti experience or equivalent within 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 be able to work in different shifts as per the work requirement.
• Strong working experience with Microsoft suite of applications (Word, Excel, PowerPoint, Visio, Outlook).

Qualifications (continued)

• At least 1-year Cotiviti experience is recommended for individuals seeking their next opportunity internally.
• 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, 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. 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.

Benefits

• Base compensation ranges from $70,000 to $90,000 per year.
• Discretionary bonus consideration.
• 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.