United States · Remote Solely
$103k–$128k/yr
Overview The Product Manager – Fraud, Waste, and Abuse (FWA) is responsible for driving the strategy, development, and lifecycle management of Cotiviti’s FWA product suite, including advanced analytics-driven solutions d…
Skills: Product Management, Fraud Waste & Abuse Detection, Healthcare Payment Integrity, Roadmap Development, Market Requirements Documentation
United States · Remote Solely
$150k–$170k/yr
Overview The Sr. Director is responsible for ensuring the day-to-day operational engine of Health Enablement runs seamlessly, predictably and at scale. This role serves as a run the business operator across delivery, ven…
Skills: Operational Excellence, Vendor Management, Risk Adjustment, Healthcare Operations, Program Management
United States · Remote Solely
$153k–$180k/yr
Overview The Sr Data Scientist - Generative AI II will apply knowledge and expertise to real world problems to enable healthcare organizations to deliver better care at lower cost through advanced technology and data ana…
Skills: Generative AI, Natural Language Processing, Large Language Models, PyTorch, TensorFlow
United States · Remote Solely
$70k–$90k/yr
Overview As a Senior Investigator, you will investigate suspected incidents of healthcare fraud, waste, or abuse through data analysis (a high level of proficiency with Excel is required). This is not a physical investig…
Skills: Data Analysis, Excel, Healthcare Fraud Investigation, Interviewing, Report Writing
United States · Remote Solely
$85k–$117k/yr
Overview The Implementation Manager is accountable for the operational execution of the project plan for new customers or new projects specific to existing customers. They will partner with the client services organizati…
Skills: Project Implementation, Cross-functional Leadership, Operational Reporting, Change Management, Client Relationship Management
United States · Remote OK
$69k–$81k/yr
Overview Cotiviti is a leading analytics and technology company in the healthcare industry, providing solutions that help health plans and providers improve payment accuracy, risk adjustment, quality, and clinical outcom…
Skills: Project Management, Data Analysis, Process Improvement, Product Configuration, Technical Troubleshooting
United States · Remote Solely
Overview This auditing role will focus on Coding & Clinical Chart Validation for our Outpatient and Specialty audits. The ideal candidate for this position needs to have both a clinical (nurse) and a coding / auditing ba…
Skills: Clinical Chart Validation, Medical Coding, Outpatient Auditing, Medical Necessity Review, ICD-10
United States · Remote Solely
$100k–$125k/yr
Overview The Drug and Biological Policy (D&B) Content Analyst II is a key member of the clinical operations and content team and is responsible for the research, quality assurance, and maintenance of existing D&B policie…
Skills: Clinical Coding, Medical Policy Research, Drug Information, Data Analysis, Business Logic Writing
United States · Remote Solely
Overview This DRG Validation Auditor role is focused on our Cross Claim Clinical Reviews (CCCR). Auditors in this role will be doing DRG Validation for our prepay and retrospective audits and making determinations withou…
Skills: DRG Validation, ICD-10 Coding, Clinical Validation, Claims Auditing, Medical Necessity Review
United States · Remote Solely
$125k–$150k/yr
Overview The Sr Gen AI Data Scientist I - Generative AI will apply knowledge and experience to real world problems and seek to utilize their skills reduce the cost of healthcare and improve health quality and outcomes. W…
Skills: Generative AI, Natural Language Processing, Large Language Models, Fine-tuning LLMs, HuggingFace
United States · Remote Solely
$22/hr–$26/hr
Overview A Payment Accuracy, Coordination of Benefits (COB) Specialist 1 is a member of the greater Coordination of Benefits Business Unit (BU). Coordination of Benefits involves situations in which an individual is cove…
Skills: Coordination of Benefits, Data Analysis, CMS Guidelines, NAIC Guidelines, Audit Tools
Pune City Subdistrict, Maharashtra, India · On-site
Overview We are currently seeking a manager to manage Medical Coding programs. His/her Primary responsibility will be to support and monitor day-to-day work processes and meet production and Service Level Agreements. Ass…
Skills: Medical Coding, Operations Management, SLA Management, Resource Planning, Performance Management
Coimbatore, Tamil Nadu, India · Hybrid
Overview PRINCIPLE PURPOSE OF JOB We are currently seeking Team Leader to support a growing client base and manage the day-to-day operational activities of the production team and to help stabilization of the process com…
Skills: Clinical Validation, Medical Coding, Team Leadership, Payment Accuracy, SLA Management
Pune, Maharashtra, India · On-site
Overview General Summary: We are currently seeking Auditor to support a growing client base while combining their clinical and/or coding expertise with payment accuracy. The Auditor is responsible for analyzing and inter…
Skills: Medical Coding, Clinical Auditing, DRG Experience, ICD-10 CM, Payment Accuracy
United States · Remote Solely
$70k–$90k/yr
Overview As a Senior Investigator, you will investigate suspected incidents of healthcare fraud, waste, or abuse through data analysis (a high level of proficiency with Excel is required). This is not a physical investig…
Skills: Data Analysis, Healthcare Fraud Investigation, Excel, Data Mining, Sampling
United States · Remote Solely
$96k–$116k/yr
Overview This new and evolving position includes diverse responsibilities such as assisting with the alignment in the Outpatient Specialty (OPSP) policies across Commercial and Government and assisting with project work …
Skills: Project Management, Data Analysis, Process Improvement, KPI Monitoring, Healthcare Billing
United States · Remote Solely
$101k–$132k/yr
Overview At Cotiviti, we are custodians of data for our clients. Using their technical experience in ETL processes, Data Engineers ensure operational functions are occurring as expected. This includes but is not limited …
Skills: Spark, Databricks, SQL, AWS, Azure
United States · Remote Solely
$70k–$91k/yr
Overview As a Medical Reviewer, you will be auditing medical records to evaluate the accuracy of medical coding and health plan policies for our Fraud, Waste & Abuse clients. Responsibilities Conducts audit of medical re…
Skills: Medical Auditing, Medical Coding, Fraud Waste and Abuse Detection, ICD, CPT
United States · Remote OK
$82k–$102k/yr
Overview The Coding Manager leads a team of coders, directly or indirectly, to deliver key components to the Cotiviti coding program. This role works with the Director of Coding, the Client team and other areas related t…
Skills: HCC Medical Coding, Staff Management, Production Planning, Quality Assurance, Data Analysis
United States · Remote OK
$82k–$104k/yr
Overview The Team Lead is a member of the Coordination of Benefits team, involving situations in which an individual is covered by two or more health plans. Individuals in the Senior Specialist Team Lead role are passion…
Skills: Performance Management, Coordination of Benefits, Team Leadership, Recruiting, Coaching
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Drive the strategy and lifecycle management of the Fraud, Waste, and Abuse product suite to improve healthcare payment integrity. Collaborate with cross-functional teams to translate market needs into scalable analytics-driven solutions and integrated platforms.
Requires a bachelor's degree and 3-5+ years of product management experience, preferably within healthcare FWA. Candidates should possess strong analytical skills and experience with AI/ML initiatives and software development.
The Product Manager – Fraud, Waste, and Abuse (FWA) is responsible for driving the strategy, development, and lifecycle management of Cotiviti’s FWA product suite, including advanced analytics-driven solutions designed to identify and prevent improper healthcare billing. This role works at the intersection of product, analytics, operations, and client engagement to deliver high-impact solutions that improve payment integrity outcomes for healthcare payers.
The Product Manager partners closely with cross-functional teams including R&D, data science, operations, implementations, and product marketing to define product vision, prioritize roadmap investments, and ensure successful delivery of scalable, client-ready solutions. This includes translating complex market and client needs into actionable product requirements, supporting go-to-market activities, and ensuring solutions are aligned with evolving regulatory and industry demands.
The role requires strong domain expertise in healthcare payment integrity and/or fraud, waste, and abuse, along with experience working in analytics-driven or workflow-based applications. Products within this space leverage rules-based detection, machine learning models, and integrated case management workflows to identify suspect provider behavior, support investigations, and drive financial recoveries.
Success in this role requires the ability to balance strategic thinking with execution, manage competing priorities in a fast-paced environment, and influence stakeholders across a highly matrixed organization. The Product Manager will play a key role in advancing Cotiviti’s broader FWA strategy, including the evolution toward integrated end-to-end solutions that combine prepay and postpay fraud detection capabilities into a unified platform experience.
This job description is intended to describe the general nature and level of work being performed and is not to be construed as an exhaustive list of responsibilities, duties and skills required. This job description does not constitute an employment agreement and is subject to change as the needs of Cotiviti and requirements of the job change.
Physical Requirements and Working Conditions:
Base compensation ranges from $103,000 to $128,000 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.
This role is based remotely and all interviews will be conducted virtually.
Date of posting: 06/22/2026
Applications are assessed on a rolling basis. We anticipate that the application window will close on 08/22/2026, 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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The infrastructure layer powering healthcare
Cotiviti enables healthcare organizations to deliver better care at lower cost through advanced technology and data analytics that improve the quality and sustainability of healthcare in the United States. Cotiviti’s solutions increase transparency and collaboration between payers and providers while empowering them to reduce medical and administrative costs, enable better health, improve claims payment efficiency, streamline operations, drive interoperability, and advance value-based care. Its customers serve the majority of U.S. healthcare consumers, providing coverage and care for over 300 million members and patients. Additionally, Cotiviti offers data management and recovery audit services to the retail sector to improve business outcomes. For more information, visit www.cotiviti.com.
Offices: 10701 S River Front Pkwy, Unit 200, Unit 200, South Jordan, UT 84095, US
The infrastructure layer powering healthcare
Cotiviti enables healthcare organizations to deliver better care at lower cost through advanced technology and data analytics that improve the quality and sustainability of healthcare in the United States. Cotiviti’s solutions increase transparency and collaboration between payers and providers while empowering them to reduce medical and administrative costs, enable better health, improve claims payment efficiency, streamline operations, drive interoperability, and advance value-based care. Its customers serve the majority of U.S. healthcare consumers, providing coverage and care for over 300 million members and patients. Additionally, Cotiviti offers data management and recovery audit services to the retail sector to improve business outcomes. For more information, visit www.cotiviti.com.
Offices: 10701 S River Front Pkwy, Unit 200, Unit 200, South Jordan, UT 84095, US
