Remote Client Policy & Payment Manager

Cotiviti; United States; Remote; USD 78,000 - 106,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Disability insurance

Life insurance

401(k) plan

Paid holidays

PTO

Job summary

Cotiviti's Client Policy Manager I is responsible for ensuring client payment policies are accurate, up-to-date, and complete, and for acting as the liaison between the Cotiviti team and the client. The role drives periodic update analysis, reviews health plan rules, prepares policy documents, and collaborates with Medical Directors and client teams.

This remote position can be located anywhere in the continental US, with travel up to 20% and a base salary range of $78,000 to $106,000 per year,

Qualifications

• This role requires an active license or healthcare-related degree and related experience.
• Strong knowledge of healthcare claims payment policy and processing.
• Experience in claims adjudication or utilization review for managed care or healthcare insurers.
• Excellent communication and client-management abilities in healthcare settings.
• Ability to analyze data and articulate medical policies clearly.
• Ability to work independently and in teams under tight deadlines.
• Familiarity with CMS guidelines and health plan operations.

Responsibilities

• Manage integrity of client medical policy sets and liaise with client teams.
• Drive periodic update analysis and industry updates for policy accuracy.
• Prepare payment policy documents for client presentations and reviews.
• Conduct research and analysis for medical policy items with guidance from Cotiviti leaders.
• Review and present policies for internal review and client acceptance.
• Contribute to policy content improvements and document client sensitivities.
• Communicate effectively with internal and external client teams.
• Perform data and report analytics and apply project management principles.
• Analyze client inquiries and apply decisions to affected policies.

Skills

Healthcare policy knowledge

CMS guidelines knowledge

Analytical skills

Communication skills

Data analysis

Project management

Confidential information handling

Education

Registered Nurse license

BSN preferred

Bachelor's Degree in Healthcare related field

Tools

Microsoft Office

Job description

Cotiviti's Client Policy Manager I is responsible for ensuring client payment policies are accurate, up-to-date, and complete, and for acting as the liaison between the Cotiviti team and the client. The role drives periodic update analysis, reviews health plan rules, prepares policy documents, and collaborates with Medical Directors and client teams.

This remote position can be located anywhere in the continental US, with travel up to 20% and a base salary range of $78,000 to $106,000 per year,