CotivitiCO

Director Audit Operations (Contract Compliance Recovery Audit)

Cotiviti is a solutions and analytics company that leverages clinical and financial datasets to provide insights into the performance of the healthcare system, focusing on payment accuracy, risk adjustment, quality improvement, and consumer engagement. It also serves the retail industry with data management and recovery audit services.

Cotiviti

Employee count: 5000+

Salary: 175k-225k USD

United States only

Overview

The Director, Audit Operations (Contract Compliance Recovery Audit) position is responsible for providing leadership and management for our vast and expanding global client base. Oversee the existing and expanding team in the delivery of all contract review and financial audit activities for assigned accounts to maximize team performance, ensure our client’s service providers are fulfilling their contractual obligations, achieve internal and client financial and operations objectives, and deliver customer satisfaction consistent with established operating practices and audit procedures. This will be accomplished through effective audit operations management, quality and service assurance, and effective people management and development. The Director will manage the team with an emphasized focus on audit acceleration, increasing workload, effective recovery collections and expanding services to new client base.

Responsibilities

  • Directs the successful delivery of recovery audit services to the client by managing the team(s) assigned to the engagement and providing leadership and direction and ensuring that the client's needs and expectations are met and exceeded. Develop and implements key metrics to drive performance in quality and productivity and to ensure that the customer experience is consistent and satisfactory across all phases of the audit.
  • Continually works to improve efficiency, productivity, predictability, speed to resolution and reduce operational costs.
  • Builds, by client, the annual budgets of Gross ID, void/paybacks, and throughout the fiscal year, continues to track and forecast against said budgets.
  • Is required to have a global Cotiviti and Retail Division perspective, understanding both short- and long- term priorities within their area of responsibility and throughout the greater organization.
  • Continually work to improve efficiency, productivity and reduce operational costs while providing 100% compliance with customer contract and company policies.
  • Supports the continuous development of innovative solutions and audit concepts.
  • Strategically navigates through customer issues and conflict, including direct communication with customers to achieve mutually accepted resolution. Provides assistance and removes barriers as needed to identify opportunities for process improvements. Serves as top escalation point to resolve any customer issues that are roadblocks to customer satisfaction. Leads the implementation of all appropriate actions by other leaders and teams to understand and resolve issue and ensures follow through until closure and complete customer satisfaction. Serves as an escalation point to resolve any customer issues (Internal and External).
  • Consistent with good people management practices and company values
  • Management of direct reports including all corporate duties associated with people leadership
  • Must own the client’s relationship at all levels within the client’s organization and work in concert with the Strategic Account Manager.
  • Partners with the client and sales team on renewals and work through any RFP process by identifying gaps in current contract in place and understanding customer needs in order to successfully renew the contract. Performs customer needs and service analysis, makes recommendations on appropriate pricing structure and contract requirements, and contribute to RFP responses. Facilitates contract terminations or scope changes including identifying reason for change, defining possible solutions to customer issues to lead to retention, negotiating account transition procedures and prices.
  • Meets regularly with audit and audit support managers to ensure appropriate staffing levels and to plan and organize workloads and staff assignments according to the needs of the audit.
  • Follow established processes for training and career progression to enable revenue growth and auditor and support staff development and engagement. Promotes & participates in knowledge sharing activities such as best practices, benchmarking, whitepapers and IT tools enhancement. Ensures that all levels of staff are properly trained on policies, procedures and best practices and that proper training, education and required certifications are maintained as required.
  • Hire, develop, coach, lead and retain top-tier talent, with a focus on building and improving a team and culture that is able to assist in employing best in class practices to support and drive high levels of internal and external customer satisfaction.
  • Complete all responsibilities as outlined in the annual performance review and/or goal setting.
  • Complete all special projects and other duties as assigned.
  • Must be able to perform duties with or without reasonable accommodation.

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.

Qualifications

  • Bachelor’s degree in business or finance; or an equivalent combination of experience and education.
  • Minimum 10 years of experience in Recovery Audit Operations, with experience managing teams and processes across multiple clients.
  • Experience specifically in the Retail and Commercial sector performing and managing contract compliance recovery audit services.
  • Must possess both strong analytical skills, and the ability to think strategically.
  • Must have strong presentation skills with both internal and external clients
  • Must have proven ability to build strong client relationships.
  • Excellent verbal and written communication skills required.
  • Advanced computer skills in Excel are required.
  • Advanced computer skills in Access preferred.
  • Prior experience with direct client contact (account management, audit, sales, etc.) required.
  • Must be comfortable working with c-suite level executives.
  • Willing to travel (potentially Internationally) to clients, Cotiviti offices, conferences, training, etc. as required.

Base compensation ranges from $175,000 to $225,000 per year. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs. This role is eligible for discretionary bonus consideration.

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: 4/10/2025

Applications are assessed on a rolling basis. We anticipate that the application window will close on 6/10/2025, but the application window may change depending on the volume of applications received or close immediately if a qualified candidate is selected.

About the job

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Job type

Full Time

Experience level

Director

Salary

Salary: 175k-225k USD

Location requirements

Hiring timezones

United States +/- 0 hours

About Cotiviti

Learn more about Cotiviti and their company culture.

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Through groundbreaking technology and profound data analytics, Cotiviti is revolutionizing the economics of healthcare. The company is at the forefront of enabling healthcare organizations to deliver enhanced care at a reduced cost, thereby ensuring the quality and sustainability of the healthcare system in the United States. Cotiviti's innovative solutions are a critical foundation for healthcare payers, empowering them in their mission to lower healthcare expenditures and elevate quality through higher-performing payment accuracy, risk adjustment, quality improvement, and consumer engagement programs. By processing and analyzing billions of clinical and financial data points, Cotiviti uncovers opportunities for clients to boost efficiency and quality, ultimately leading to better care for their members. The company's commitment to responsible AI implementation is evident in its partnership with the Responsible AI Institute, aiming to develop new ways to leverage artificial intelligence to foster a high-quality and viable healthcare system. This focus on accelerating the development of innovative healthcare technologies drives advancements in data analytics, interoperability, and value-based care solutions.

Cotiviti's expertise extends to serving the retail industry with sophisticated data management and recovery audit services designed to improve business outcomes. The company's approach is rooted in a combination of advanced technology, comprehensive data analytics, and specialized expertise. This synergy allows Cotiviti to provide solutions that address payment accuracy, quality improvement, risk adjustment, and network performance management. Cotiviti's dedication to innovation is further highlighted by its recent technological advancements, such as 360 Pattern Review, which utilizes artificial intelligence to rapidly identify potential healthcare fraud, waste, and abuse, and Zero Hour Alerts, which empowers large retailers to prevent payment errors. With a global team of over 9,000 employees, Cotiviti fosters a collaborative environment where specialized and talented teams work in tandem to ensure operational efficiency and deliver services that exceed industry standards. The company's vision is to enable a high-quality and viable healthcare system, and its mission is to improve this system through its unique blend of technology, analytics, and expertise.

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Cotiviti hiring Director Audit Operations (Contract Compliance Recovery Audit) • Remote (Work from Home) | Himalayas