Technical Customer Solutions Manager

🕒 Abril 11

🇺🇸 Estados Unidos – Remoto (EUA)

💵 $119.500 - $161.700 / ano

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

💻 Engenheiro de Soluções

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Cotiviti

SiteLinkedInTodas as Vagas

5001 - 10000 funcionários

⚕️ Seguro de Saúde

💳 Fintech

🤖 Inteligência Artificial

Healthcare Insurance • Fintech • Artificial Intelligence

Cotiviti é uma empresa de tecnologia e análise em saúde que se especializa em melhorar a precisão e o desempenho dos pagamentos por meio de soluções avançadas de análise de dados. Eles se associam a planos de saúde, agências governamentais e provedores de serviços de saúde para fornecer insights que aprimoram a qualidade e a eficiência na prestação de cuidados. Com soluções como ajuste de risco, gerenciamento de políticas de pagamento e engajamento de membros, a Cotiviti busca otimizar os resultados financeiros e clínicos para o ecossistema de saúde.

Descrição

• Develop, implement, and complete tactical project plans related to customer issue resolution, quality improvement plans, and program enhancements. • Act as the lead relationship manager for assigned accounts, coordinating proactive customer communication and cross-functional collaboration. • Lead customers to success by understanding their business needs and aligning Cotiviti software and services to drive high-impact results. • Partner with Account and Product Management on Customer Health, NPS, Executive Business Reviews (EBRs), Expansion, and Renewals by delivering against assigned KPIs. • Forecast and track operational metrics including member volumes, encounter throughput, revenue recognition, and submission accuracy. • Apply deep operational knowledge of CMS regulations and audit frameworks to ensure accurate, compliant processing. • Leverage your expertise in encounter submissions and EDI transactions (834, 837, 835, 270/271) to support client success and issue remediation. • Analyze client support tickets and product issues to identify systemic trends and advocate for internal resolution. • Serve as a key conduit for customer enhancement requests through structured feedback loops to Product Management. • Ensure all contracted deliverables are provided accurately, on schedule, and in alignment with client expectations. • 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.

🎯 Requisitos

• Master’s Degree OR a minimum of 6 years of relevant experience. • 6+ years of deep operational knowledge of data integration systems including in claim processing systems like FACETS, QNXT, SAP ECC, OR Cotiviti/Edifecs like platforms. • 6+ years of technical expertise in claims processing, encounter submissions, and risk adjustment workflows. • Fluent in Software as a Service (SaaS) distribution models. • 6+ years of Proven success in healthcare or related technical field. • Familiarity with customer journey mapping and strategic success planning. • Strong working knowledge of Microsoft Office, Freshdesk, SQL, and Jira.

🏖️ Benefícios

• medical, dental, vision, disability, and life insurance coverage • 401(k) savings plans • 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 with Cotiviti