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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in client relationship management, project management, and operational implementation within the healthcare sector. Proficient in analyzing program performance and developing corrective action plans while maintaining compliance with CMS guidelines and medical payment policies.
Highest-signal resume keywords
Client Relationship ManagementProject ManagementHealthcare Operations KnowledgeRegulatory Compliance KnowledgeMS Office Suite Proficiency
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Project ManagementClient Relationship ManagementHealthcare OperationsClaims Lifecycle KnowledgeData AnalysisPolicy ImplementationTraining DevelopmentMeeting FacilitationProblem-SolvingFinancial Acumen
Soft Skills
Excellent Communication SkillsInterpersonal SkillsOrganizational SkillsAnalytical SkillsFlexibility
Tools & Technologies
MS Office SuiteCustomer-Service Tool
Certifications & Qualifications
Bachelor’s DegreeProfessional Coder Certification (CPC, CPC-A, CCA, CCS, CCS-P, RHIT, RHIA) (Preferred)
Industry Keywords
CMS GuidelinesMedical Payment PolicyHealthcare ExperienceClient SatisfactionRevenue RetentionCross-Functional TeamsOperational SME
Tech Stack
Tools & technologiesGo
About the role
Key responsibilities & impact- Coordinate the cross-functional client team to achieve client plans, revenue retention, client satisfaction, and growth for Prospective Payment PPM and CV products
- Serve as the primary client contact, trusted advisor, internal and external liaison, and operational subject-matter resource
- Build and sustain client relationships; identify client needs, expanded opportunities, and solutions
- Collaborate with the Go-To-Market team on client strategic plans and lead tactical execution
- Promote policy adoption and acceleration through organization, communication, and project management
- Identify and communicate cross-product opportunities
- Manage operational implementation and execution of client payment policy decisions across Claims Operations, Provider Services, Appeals, Network Operations, Payment Integrity, IT, and other departments
- Coordinate and manage joint client/internal meetings, including scheduling, facilitation, agendas, materials, minutes, action items, and logistics
- Document and distribute meeting minutes and follow up on action items
- Maintain accurate, current client documentation in Cotiviti’s library
- Manage internal and external aspects of client initiatives and joint projects to ensure objectives and milestones are met
- Monitor program performance, analyze monthly reports, identify trends and root causes, and develop and execute corrective action plans
- Provide client testing support for operational and policy initiatives
- Maintain escalation plans and monitor file-processing statistics to minimize missed policy opportunities
- Coordinate production reporting to identify trends and data anomalies; develop and execute recommendations
- Administer customer-service tool user accounts, access, usage, and data accuracy
- Identify client education needs and develop and deliver client training programs
- Manage client inquiries, triage them appropriately, and ensure timely resolution
- Participate as an operational SME in department and corporate projects
- Travel up to 20%
- Complete annual performance-review goals, special projects, and other assigned duties
Requirements
What you’ll need- Bachelor’s Degree or higher (preferred), or equivalent experience, required
- Knowledge of CMS guidelines and other regulatory compliance guidelines and mandates, and medical payment policy
- Professional coder certification (CPC, CPC-A, CCA, CCS or CCS-P, RHIT or RHIA) is not necessary but a plus
- 4+ years of related healthcare experience with strong knowledge of health plan operations and claims lifecycle
- 4+ years of experience in client relationship management or consulting experience in a healthcare setting
- 4+ years of project or team management experience, including meeting facilitation and follow-through on deliverables
- Highly proficient in MS Office Suite: Excel, Word and PowerPoint
- Excellent written and verbal communication and interpersonal skills
- Strong presentation skills; prior experience delivering training classes is a plus
- Demonstrated success developing strong, trust-based professional relationships with clients in multiple roles and levels
- Ability to work independently and within a collaborative team environment or matrix structure
- Ability to organize, plan, prioritize and meet deadlines while producing high-quality, error-free deliverables
- Effective analytical and problem-solving skills and financial acumen
- Ability to properly handle confidential information
- Ability to work with on-site and remote cross-functional product teams and customers
- Flexibility and willingness to participate in international work processes and calls across global time zones
- After-hours and/or weekend work may be required for major deliverables/deadlines
- 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
- Must be able to perform duties with or without reasonable accommodation
Benefits
Comp & perks- Medical, dental, vision, disability, and life insurance coverage
- 401(k) savings plan
- Paid family leave
- 9 paid holidays per year
- 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service
- Remote work arrangement
- Dedicated, secure work area and high-speed internet access/connectivity and office setup and maintenance provided/required for remote work
