Program Manager Operations (Risk Adjustment)

Overview

The Program Manager, Operations will partner directly with the assigned Client Executive, retrieval, coding, and reporting team leads and will focus on the execution and delivery of the Cotiviti Risk Adjustment Products and Services for enterprise-level accounts. The Program Manager, Operations will directly own assigned accounts and is responsible for overseeing all aspects of our engagement for our Risk Adjustment solution set. The Program Manager, Operations will leverage their deep healthcare and project management knowledge to deliver the highest quality of services to Cotiviti clients.

Responsibilities

• Accountable for ensuring the successful delivery of products and services to a strategic client within the Cotiviti Risk Adjustment portfolio, requiring the Program Manager to partner very closely with the assigned Client Executive, retrieval, coding, and reporting team leads as well as other teams across the organization.
• Produces and manages documents related to client projects, calls, meetings, product specifications, special initiatives, and follow-up.
• Interacts directly with customers to drive client satisfaction and product adoption in support of all initiatives as defined.
• Fully accountable for ensuring that open issues are managed in a timely manner and that no key milestones are missed.
• Responsible and accountable for ensuring that the costs/expenses of managing clients are aligned with the anticipated revenue.
• Responsible for tracking and reporting on client contractual SLAs.
• Accountable for driving value of our products and solutions within the assigned customer's account ensuring the client receives ROI for their investment.
• Identify issues and obstacles that may hinder success and ensure the appropriate Cotiviti resources are working to correct these issues.
• Completes all responsibilities as outlined in the annual Performance Plan.
• Completes 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 the requirements of the job change.

Qualifications

• Bachelor's degree is required, Relevant Master’s Degree preferred.
• 4-6 years’ experience within the Healthcare or Insurance space. Experience with large payers is preferred.
• Strong knowledge of healthcare required, specifically Risk Adjustment.
• A minimum of 3 years of successful client/program management.
• Demonstrated experience managing the deliverables of a client.
• Ability to foster relationships at the appropriate level within the Client organization and take full accountability for managing client escalations.
• Proven ability to handle stressful situations, multiple tasks, and deadline pressures.
• Formal training in enterprise project management methods and process management experience is preferred.
• Outstanding presentation and communication skills. Proven success in preparing and delivering presentations that convey information critical to the audience and adjusting to meet changing audience needs.
• Ability to listen and understand information and ideas whether presented verbally or written.
• Excellent verbal, written, and interpersonal communication skills with strong grammar and writing skills.
• Able to interact easily and appropriately with internal and external individuals with a professional demeanor.
• Ability to follow up on outstanding tasks/deliverables.
• Ability to navigate cross-functional internal teams to execute complex tasks in a growing and changing environment.
• Deep knowledge of Project Management
• Excellent computer skills in Microsoft Word, Excel, PowerPoint, and Outlook are a must.
• Willingness to travel up to 15% is required.

Mental Requirements:

• Communicating with others to exchange information.
• Assessing the accuracy, neatness, and thoroughness of the work assigned.

Physical Requirements and Working Conditions:

• Remaining in a stationary position, often standing or sitting for prolonged periods.
• Repeating motions that may include the wrists, hands, and/or fingers.
• Must be able to provide a dedicated, secure work area.
• Must be able to provide high-speed internet access/connectivity and office setup and maintenance.
• No adverse environmental conditions are expected.

Base compensation ranges from $75,000 to $105,000 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.

Date of posting: 3/25/2026

Applications are assessed on a rolling basis. We anticipate that the application window will close on 05/25/2026, 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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