Program Manager Operations (HEDIS)

The Program Manager, Operations will partner directly with the assigned Program Manager, Operations and Program Director in support of a strategic client account. Responsibilities focus on the execution and delivery of the Cotiviti HEDIS/Quality Products and Services. The Program Manager is dedicated to support and manage the strategic client's account, while being responsible for oversight of all aspects of their medical record retrieval project. The Program Manager will leverage their deep healthcare and project management knowledge to deliver the highest quality of services to Cotiviti's strategic client.

Accountable for ensuring the successful delivery of products and services to a strategic client within the Quality/HEDIS Cotiviti Portfolio, requiring the Program Manager to partner very closely with the assigned Operations Program Manager, Program Director, Data Analyst, and other teams across the organization.
• Understand the client's business model and work closely with internal stakeholders to ensure objectives are met.
• Responsible for managing the client's custom end-to-end process map for the retrieval solution and ensuring compatibility with Cotiviti's HEDIS/Quality Products.
• Partner with the client and internal stakeholders for process improvement initiatives and client enhancement requests.
• Produce and manage documents related to client projects, calls, meetings, product specifications, custom initiatives, and follow-ups.
• Interact directly with the strategic client to drive satisfaction and product adoption in support of Quality Reporting and other initiatives, as defined.
• Fully accountable for ensuring that open issues are managed in a timely manner and that no key milestones are missed.
• Identify issues and obstacles that may hinder success and ensure the appropriate Cotiviti resources are working to correct these issues.
• Ability to troubleshoot on demand client/tool items and prioritize internal/external deliverables.
• 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.

• 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 and/or Quality (HEDIS).
• 2 - 5 years of experience with HEDIS.
• 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 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 on complex tasks in a growing and changing environment.
• Excellent computer skills in Microsoft Word, Excel, PowerPoint and Outlook a must.

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 $68,000 to $95,500 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: 02/05/2025

Applications are assessed on a rolling basis. We anticipate that the application window will close on 04/05/2025 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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