Senior BRMS Rules Engineer - Remote

Remote Jobs; United States; Remote; USD 85,000 - 105,000; Full time

Job summary

Cotiviti seeks a Senior Technical Specialist to manage rule intake, design and deploy business rules into BRMS, and ensure scalable rule performance. You will coordinate with RCA Content & Enablement, Implementations, and Audit Operations and R&D teams, maintaining documentation, impact analyses, and data-driven improvements.

Required are healthcare industry experience, SQL/Java coding basics, and familiarity with Power BI and BRMS tools.

Qualifications

• High School Diploma required; bachelor's preferred or equivalent experience.
• Healthcare industry experience is required.
• Basic coding skills: SQL, Java or similar languages.
• Familiarity with BI and data tooling (Power BI, SSMS, Access).
• Experience with complex business rules and rule engines (e.g., DROOLS).
• Ability to analyze large datasets and audit data quality.
• Strong communication and collaboration skills; independent work ability.
• Excellent problem-solving, organization, and presentation skills.
• Willingness to work across shifts and support remote operations.

Responsibilities

• Receive and clarify business rules from internal Cotiviti teams.
• Design and develop rule logic for BRMS integration.
• Test and validate rules in non-production environments.
• Deploy validated rules into production and monitor outcomes.
• Maintain rule documentation and version history.
• Perform impact analysis for new or revised rules.
• Identify gaps and root causes to improve rule effectiveness.
• Develop data-driven solutions to optimize performance.
• Collaborate with operations to socialize rules and gather feedback.
• Produce reports on rule effectiveness and content trends.
• Explore automation and workflow enhancements with tools like Power Automate, JIRA, and Asana.
• Assist with training and transition of operational tasks to downstream teams.

Skills

SQL

Java

Healthcare experience

Analytical thinking

Independent worker

Education

High School Diploma

Bachelor's degree or equivalent

Tools

Access

HUE

Datameer

Power BI

SSMS

Job description

Cotiviti seeks a Senior Technical Specialist to manage rule intake, design and deploy business rules into BRMS, and ensure scalable rule performance. You will coordinate with RCA Content & Enablement, Implementations, and Audit Operations and R&D teams, maintaining documentation, impact analyses, and data-driven improvements.

Required are healthcare industry experience, SQL/Java coding basics, and familiarity with Power BI and BRMS tools.