Remote Healthcare BRMS Rule Engineer

Cotiviti; Idaho; On-site; USD 70,000 - 90,000; Full time

Benefits offered by this job

Discretionary bonus consideration

Competitive benefits package

Paid time off

Job summary

Cotiviti is seeking a Technical Specialist to collaborate with RCA - Content & Enablement, Implementations, Audit Operations and R&D teams to create and deploy business rules for the new platform. You will maintain rule documentation and perform impact analyses for each rule while coordinating with the BRMS Center of Excellence.

The role emphasizes rule logic development, deployment testing, production rollout, and ongoing collaboration with operations to meet business needs.

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.
• 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.
• Strong working experience with Microsoft suite of applications (Word, Excel, PowerPoint, Visio, Outlook).
• At least 1-year Cotiviti experience is recommended for individuals seeking their next opportunity internally.

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 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.

Skills

Basic coding skills

SQL

Java

Analytical thinking

Communication

Education

Bachelor’s degree in education, technical writing, communications

Equivalent experience considered

Tools

Access

HUE

Datameer

Power BI

SSMS

DROOLS

Job description

Cotiviti is seeking a Technical Specialist to collaborate with RCA - Content & Enablement, Implementations, Audit Operations and R&D teams to create and deploy business rules for the new platform. You will maintain rule documentation and perform impact analyses for each rule while coordinating with the BRMS Center of Excellence.

The role emphasizes rule logic development, deployment testing, production rollout, and ongoing collaboration with operations to meet business needs.