{"id":465344,"url":"https://alion.io/job/cotiviti-client-policy-manager","title":"Client Policy Manager","company":{"id":706,"name":"Cotiviti","domain":"cotiviti.com","url":"https://alion.io/company/cotiviti","size_band":"1001-5000","is_staffing_agency":false,"employer_type":"direct","is_intermediary":false,"listed_via":null,"ats_vendor":"iCIMS","truth_index":null},"role":"Public Policy","role_family":"Public Policy","seniority":"middle","employment_type":null,"work_mode":"remote","remote_scope":"stated_countries","remote_scope_basis":"board_field","remote_working_hours":null,"hiring_geo_confidence":"structured","locations":["United States"],"countries":["US"],"hiring_countries":["US"],"hiring_countries_total":1,"salary":{"min":78000,"max":106000,"currency":"USD","period":"year","gross":null,"usd_annual":106000},"salary_estimate":null,"experience_years_min":3,"visa_sponsorship":false,"relocation_package":false,"has_equity":false,"technologies":[{"name":"Microsoft Office","optional":false}],"status":"live","first_seen_at":"2026-09-06T12:11:13Z","employer_posted_date":"2026-10-15","last_verified_at":"2026-10-17T07:45:24Z","board_verified":true,"closed_at":null,"days_open":40,"trust":{"level":"ok","repost_count":null,"flags":[],"days_open":40},"description":"Overview\nThe Client Policy Manager I manages client payment policies by ensuring client’s payment policy is accurate, up-to-date, and complete; executes client-specific requests with guidance from internal team and acts as the internal and external client team liaison.\nResponsibilities\nThis position is client facing and requires a commitment to superior client service.\nPrimarily responsible for the integrity of the client’s medical policy set, including awareness of all client-related Medical Policy project requests, monthly review of Max Units, review of Health Plan rules, etc.\nPrimary driver of the Periodic Update analysis and industry updates. Review and identify changes needed to client policies in order to maintain up-to-date and accurate medical payment policies. \nPrepare payment policy documents for presentation to the client. Review all documents and coordinate reviews with Medical Directors and participate in client policy meetings. \nConduct research and analysis for medical policy items with guidance from Cotiviti Client Medical Director and Content. \nReview client payment policies for accuracy, complete reviews on a timely basis, clearly understand and articulate medical policies, present the policies for consideration to Cotiviti Client Medical Director for review and acceptance by the client, provide direction on client understanding of medical policies. \nAdd value to medical policy content, department, and client teams by participating and offering benefit of knowledge and experience proactively. \nClearly understand, document and maintain client medical policy sensitivities and nuances in the Client Profile Workbook. \nCommunicate effectively with various members of the client team (internal as well as external). \nPerform multi-faceted data and report analytics. \nApply project management principles in initiating, creating, and managing projects. \nReview and analyze client inquiries for clarity of intent, apply decisions for affected policies, maintain information, and communicate effectively with the client. \nCompletes all responsibilities as outlined on annual Performance Plan. \nCompletes all special projects and other duties as assigned.\nThis 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.\nQualifications\nActive professional license as a Registered Nurse (BSN preferred) or Bachelor’s Degree in Healthcare related field or relative experience. \nProfessional coder certification (CPC, CPC-H, CPC-P or CCS-P). \nMinimum of 3 years clinical coding experience, preferable in a payer setting. \nStrong knowledge of healthcare claims payment policy and processing, specifically, CMS, Medicaid, ICD, CPT, HCPCS and other specialty society, etc. \nExperience in claims adjudication or utilization review working for a managed care or healthcare insurance company. \nFamiliarity with claims payment and reimbursement methodologies. \nExperience in customer service or client management with a strong focus on healthcare setting. \nClearly understands and articulates medical policies. \nStrong Knowledge of CMS guidelines. Health plans, Managed Care or Health Care insurance company experience. \nPrior experience in developing medical payment policy edits. \nProficiency in Microsoft Office suite. \nDemonstrated problem-solving skills. \nProfessional with ability to properly handle confidential information. \nAbility to work well both independently and collaboratively, in a fast-paced and demanding environment. \nAbility to analyze data and synthesize it for customer and internal consumption. \nEffective verbal and written communication, and interpersonal skills. \nEffective at managing timelines and multiple projects with the ability to prioritize and meet deadlines.\nCognitive/Mental Requirements:\nMust have flexibility and willingness to participate in the work processes of an international organization, including conference calls scheduled to accommodate global time zones.\nMust be able to perform duties with or without reasonable accommodation.\nCommunicating with others to exchange information.\nAssessing the accuracy, neatness, and thoroughness of the work assigned.\nPhysical Requirements and Working Conditions:\nThis remote role can be located anywhere in the continental US.\nTravel requirement up to 20%.\nMust be able to lift up to 20 lbs without assistance.\nAfter-hours and/or weekend work may be required where necessary for major deliverables /deadlines.\nMust be able to sit and use a computer keyboard for extended periods.\nRemaining in a stationary position, often standing or sitting for prolonged periods.\nRepeating motions that may include the wrists, hands, and/or fingers.\nMust be able to provide a dedicated, secure work area.\nMust be able to provide high-speed internet access/connectivity and office setup and maintenance.\nNo adverse environmental conditions are expected.\nBase compensation ranges from $78,000 to $106,000 per year. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs.\nCotiviti 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.\nDate of posting: 10/15/2026\nApplications are assessed on a rolling basis. We anticipate that the application window will close on 12/15/2026, but the application window may change depending on the volume of applications received or close immediately if a qualified candidate is selected.","description_format":"text","description_chars":6064,"description_truncated":false,"requirements":{"experience_years_min":3,"management_years_min":null,"team_size_min":null,"manages_managers":false,"education":{"level":"bachelor","optional":true},"security_clearance":false,"languages":[]},"benefits":["Insurance coverage","Life insurance","Parental leave"],"hiring_locations":[{"name":"United States","iso":"US","kind":"country"}],"hiring_excludes":[],"relocation_offered":false,"industries":["Revenue Cycle & Medical Billing","Health Data & Interoperability"],"lifecycle":[{"event":"open","at":"2026-09-06T12:11:13Z"}],"visa":[{"country":"US","licensed_sponsor":true,"evidence":"H-1B filings in 12 months: 187 · green card filings: 35","filings_12m":187,"filings_prev_12m":141,"green_card_filings_12m":35,"median_offered_wage_usd":133288,"route":null,"cap_exempt":false,"checked_at":"2026-10-15T11:24:14+00:00","sources":["US Department of Labor: LCA disclosure data (H-1B, H-1B1, E-3)","US Department of Labor: PERM disclosure data (green cards)"],"filings_for_role_12m":0}],"liveness":{"score":18,"band":"cold","label":"Long shot","p_open":1,"p_active":0.528,"p_room":0.35,"age_days":40,"expected_fill_days":10,"reasons":["conf:1","urgency","velocity","win:tail"],"computed_at":"2026-10-17T05:46:00Z"},"pay":{"stated_usd_annual":106000,"is_top_pay":false},"html_url":"https://alion.io/job/cotiviti-client-policy-manager","json_url":"https://alion.io/job/cotiviti-client-policy-manager.json","meta":{"generated_at":"2026-10-17T09:42:52Z","cache_seconds":300,"methodology":"https://alion.io/methodology","terms":"https://alion.io/terms","contact":"https://alion.io/contact","api":"https://alion.io/developers","about":"Alion is a live layer of people, companies and AI agents: who they are, whether they are real and active right now, what they do and how to work with them, readable by people and by agents and paid per call.","catalog":"https://alion.io/catalog.json","usage":{"tier":"crawler_verified","counted_by":"address","units_charged":1,"used_today":12799,"day_limit":null,"remaining_today":null,"minute_limit":300,"resets_at":"2026-10-18T00:00:00Z"}},"offers":[{"id":"company.slices","title":"One company in depth, by slice","status":"live","price":{"credits":0.02,"usd":0.002,"plus_per_slice":{"credits":0.05,"usd":0.005}},"unit":"per company, plus each slice with data","note":"the employer in depth","call":{"mcp_tool":"get_company","arguments":{"id":706},"rest":"https://alion.io/mcp/rest/get_company?id=706"},"human":"https://alion.io/catalog?offer=company.slices&for=job%2Fcotiviti-client-policy-manager"},{"id":"market.stats","title":"A market slice: pay, demand and time to fill","status":"live","price":{"credits":1,"usd":0.1},"unit":"per slice","note":"pay, demand and time to fill for this role and place","call":{"mcp_tool":"market_stats"},"human":"https://alion.io/catalog?offer=market.stats&for=job%2Fcotiviti-client-policy-manager"},{"id":"job.search","title":"Open jobs by role, technology, place, pay and visa","status":"live","price":{"credits":0.02,"usd":0.002},"unit":"per posting in a list","note":"similar open postings","call":{"mcp_tool":"search_jobs"},"human":"https://alion.io/catalog?offer=job.search&for=job%2Fcotiviti-client-policy-manager"},{"id":"company.verify","title":"Is this company real and active right now","status":"pilot","price":null,"unit":"per company","request":{"url":"https://alion.io/catalog/request","method":"POST","body":"{\"offer\": \"company.verify\", \"for\": \"job/cotiviti-client-policy-manager\", \"note\": \"what you need it for\"}"},"human":"https://alion.io/catalog?offer=company.verify&for=job%2Fcotiviti-client-policy-manager"}]}