Content Solutions Analyst I

Davita Inc.; United States; Remote; USD 95,000 - 115,000; Full time

Job summary

A leading healthcare solutions company is seeking a Content Solutions Analyst I to research and analyze medical policies. The candidate will work independently and collaboratively in a fast-paced environment, requiring strong analytical skills and a background in clinical settings. This full-time role offers a competitive salary and benefits, emphasizing the importance of delivering high-quality results in the healthcare industry.

Benefits

Medical, dental, vision insurance

401(k) savings plan

Paid Time Off (PTO)

Paid family leave

Paid holidays

Qualifications

• Must have 3 years in clinical/retail setting as nurse, pharmacist, or physician, OR 3 years clinical coding experience.
• Familiarity with claims payment and reimbursement methodologies required.
• Willingness to obtain certifications like RHIA, RHIT, CPC within a year.

Responsibilities

• Analyze complex data related to claims and medical policies.
• Write business logic for new policy enhancements.
• Collaborate with developers on rule engine enhancements.

Skills

Analytical skills

Problem-solving skills

Communication skills

Time management

Education

BS in Nursing

Pharmacy degree (BSPharm or PharmD)

Other Bachelor’s degree

Tools

Microsoft Office Suite

Job description

Content Solutions Analyst I

Job Locations

US-Remote

ID

2025-15573

Category

Clinical

Position Type

Full-Time

Overview

The Content Solutions Analyst I is a key member of the clinical operations and content team responsible for the research, quality assurance, and opportunity analysis associated with new medical policies. In addition, this position will be responsible for review and analysis of current medical policies and assisting in the research necessary to define additional logic and algorithms to expand the Cotiviti payment policy library.

Responsibilities

Familiarity with claims payment and reimbursement methodologies as well as medical policy rules and edits.
• Ability to analyze complex data and synthesize it for customer and internal consumption.
• Ability to work well both independently and collaboratively, in a fast-paced and demanding environment.
• Effective at managing timelines and multiple projects with high accuracy and attention to detail.
• Provide coding, claims processing and industry expertise to help create clinical coding policy or pharmacy claims editing policy.
• Responsible for writing business logic for new rules and enhancements by translating industry references into Cotiviti policy.
• Provide input on any new, or complex enhancements to the rule engine developers as well as system architects.
• Work within the ART, specifically providing guidance and input to TPO's/developers during grooming sessions.
• Work with Product and the Go to Market teams, to provide coding and clinical expertise for new policy rollout.
• Ensure internal Cotiviti operational teams have a clear vision and understanding of the content solutions roadmap to ensure lock step on incoming work.
• This position requires maximum guidance from mentors and leadership.
• Perform multi-faceted analytics for data and report analysis with minimal direction.

Qualifications

Education & Certification:

• BS in Nursing.
• Pharmacist (BSPharm or PharmD).
• Off-shore Medical or Pharmacy degree (MBBS or higher).
• Other Bachelors degree (or equivalent work experience).

AND

• RHIA, RHIT, CPC, CPC-H, CCS-P, SAFe, CPhT OR willingness to obtain certification within one year of employment.

Experience:

• 3 years in clinical/retail setting as nurse, pharmacist, or physician, OR 3 years clinical coding in payer setting.
• An additional 3 years research experience related to coding (CPT, HCPCS, ICD, NDC) OR at least 3 years in an internal Cotiviti role (CPM, CSM, Content Analyst, etc.).
• 5 years previous experience in detailed rule requirement gathering, rule development, and collaborating on software enhancements required.
• Strong analytical, critical thinking and problem-solving skills.
• Proficiency in Microsoft Office Suite.
• Excellent interpersonal, verbal and written communication skills.

Job Demands:

• Must have flexibility and willingness to participate in the work processes of an international organization.
• After hours and/or weekend work required where necessary for major deliverables/deadlines (not consistent).

Mental Requirements:

• Communicating with others to exchange information.
• Assessing the accuracy, neatness, and thoroughness of the work assigned.

Physical Requirements and Working Conditions:

• Remaining in a stationary position, often standing or sitting for prolonged periods.
• Repeating motions that may include the wrists, hands, and/or fingers.
• Must be able to provide a dedicated, secure work area.
• Must be able to provide high-speed internet access/connectivity and office setup and maintenance.
• No adverse environmental conditions expected.

Base compensation ranges from $95,000 to $115,000 per year. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs.

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. For information about our benefits package, please refer to our Careers page.

Date of posting: 05/29/2025
Applications are assessed on a rolling basis. We anticipate that the application window will close on 07/29/2025, but the application window may change depending on the volume of applications received or close immediately if a qualified candidate is selected.

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