Sales VP, Pharmacy Claim Editing Solutions

Cotiviti

. Own and execute a new sales strategy for Cotiviti’s Pharmacy Claim Editing and Accuracy solutions within an assigned U.S.

Posted 10/7/2026full-timeRemote • United StatesLead💰 $145,000 - $190,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates extensive experience in enterprise healthcare sales, particularly in pharmacy claim editing and payment accuracy, with a strong ability to build relationships with C-suite stakeholders. Proficient in managing complex sales cycles and articulating ROI and value propositions in a competitive market.

Highest-signal resume keywords

Enterprise Healthcare SalesPharmacy Claim EditingC-Suite Relationship ManagementSalesforce CRM ProficiencyPayment Integrity Knowledge

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Pharmacy Claims ProcessingPayment AccuracyUtilization ManagementContract NegotiationMarket AnalysisROI ArticulationSales Pipeline ManagementForecastingAccount PlanningCompliance Standards

Soft Skills

Outstanding Verbal CommunicationPresentation SkillsInterpersonal SkillsOrganizational SkillsSelf-Directed

Tools & Technologies

SalesforceMS DynamicsCRM Platforms

Industry Keywords

Health PlansTPAsPharmacy Benefit OrganizationsMedicare AdvantageMedicaid MCOsNCPDP StandardsClinical EditsFormulary ManagementSelf-Funded Pharmacy BenefitsCAA Fiduciary Requirements

About the role

Key responsibilities & impact

Own and execute a new sales strategy for Cotiviti’s Pharmacy Claim Editing and Accuracy solutions within an assigned U.S. territory
Prospect, qualify, and close new opportunities with health plans, payer-owned PBMs, TPAs, and self-funded plan administrators
Develop and maintain senior-level relationships with health plan, TPA, pharmacy operations, claims, payment integrity, compliance, finance, procurement, and benefits stakeholders
Lead complex, multi-stakeholder sales cycles involving pharmacy claim accuracy, payment integrity, ROI, savings validation, performance guarantees, and software-plus-services contracts
Develop territory and account plans aligned with pharmacy market dynamics, customer priorities, and competitive conditions
Collaborate with Product, Clinical Pharmacy SMEs, Legal, and Implementation teams on solution positioning, executive business cases, RFPs, procurement processes, and value propositions
Monitor competitive activity, pricing trends, and market conditions related to pharmacy claim accuracy and claims auditing
Represent Cotiviti at pharmacy conferences, industry forums, and executive briefings
Maintain accurate pipeline management, forecasting, and opportunity tracking in Cotiviti’s CRM
Provide sales leadership with updates on pipeline health, forecast risk, market intelligence, and customer feedback
Ensure sales activities comply with Cotiviti policies, compliance standards, contracting guidelines, budgets, and performance plans
Research environmental and competitive conditions, customer needs, and market trends; recommend strategies to capitalize on opportunities
Recommend improvements to sales and service delivery programs and procedures
Complete special projects and other assigned duties

Requirements

What you’ll need

Bachelor’s Degree required or equivalent relevant experience in Healthcare, Business, Marketing, or related field
12–15 years of experience in enterprise healthcare hunter sales
Minimum 5+ years selling into health plans, TPAs, or pharmacy benefit organizations; 7+ years preferred
Proven success selling pharmacy claim editing, payment accuracy, utilization management, or related Rx industry services
Experience selling into at least two buyer segments: commercial health plans, Medicare Advantage/Part D plans, Medicaid MCOs, payer-owned PBMs, TPAs, or self-funded employer plans
Experience closing deals ranging from hundreds of thousands to multi-million-dollar contract values
Extensive experience selling to C-suite, SVP, and VP-level stakeholders across payer and TPA organizations
Strong understanding of pharmacy claims processing and adjudication workflows across retail, mail, and specialty channels
Knowledge of NCPDP standards, benefit design, clinical edits, formulary management, and pricing methodologies including AWP, WAC, MAC, and NADAC
Familiarity with Medicaid pharmacy programs and commercial pharmacy benefits
Familiarity with Medicare Part D payment integrity, CMS compliance requirements, and rebate/DIR dynamics
Understanding of self-funded/ASO pharmacy benefit structures, TPA operating models, and CAA fiduciary/transparency requirements
Existing executive-level network within health plan and/or TPA pharmacy organizations strongly preferred
Excellent command of enterprise selling disciplines and structured close processes
Strong financial acumen and ability to articulate ROI, savings realization, and value-based pricing
Highly organized, self-directed, and effective in a remote, high-growth environment
Outstanding verbal, written, and presentation skills for executive audiences
Ability to manage complex pursuits and internal deal teams
Experience using Salesforce, MS Dynamics, or comparable CRM platforms
Ability and willingness to travel 40–60%
Strong analytical, research, prospecting, interpersonal, oral, and written skills
Ability to perform daily functions with little or no direct supervision
Ability to provide a dedicated, secure work area
Ability to provide high-speed internet access/connectivity and office setup and maintenance

Benefits

Comp & perks

Commission eligibility
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 level and length of service
Remote work
Virtual interviews
Dedicated secure work area and high-speed internet access/office setup provided by the team member