Qureos Mentor

Cotiviti

<div>Overview:
<div>
The <b>Staff Gen AI Scientist</b> will apply knowledge and experience to real world problems and seek to improve health quality outcomes and reduce the cost of healthcare. With access to dedicated on premise and cloud based big data solutions, the team can work with a vast amount of structured and unstructured data including claims, membership, physician demographics, medical records and others to begin to solve some of the most pressing healthcare issues of our time. A Data Scientist at Cotiviti will be given the opportunity to work directly with a team of healthcare professionals including analysts, clinicians, coding specialists, auditors and innovators to set aggressive goals and execute on them with the team. This is for an ambitious technologist, with the flexibility and personal drive to succeed in a dynamic environment where they are judged based on their direct impact to business outcomes.</div><div></div><div><i><br>
Please note:</i><i> We are currently hiring multiple positions at various levels for our Artificial Intelligence teams. Please use the chart below as a general guide for the amount of experience required for each level, and apply to the req(s) that are most appropriate for your level of experience.</i></div><br>
<div></div>
Responsibilities:
<p>
As a <b>Staff Gen AI Scientist</b> within Cotiviti you will be responsible for delivering solutions that help our clients improve the quality of healthcare outcomes, reduce the cost of healthcare processes, and/or identify payment integrity issues. You will work as part of a team and will be individually responsible for the delivery of value associated with your projects. You will be expected to follow processes and practices that allow your models to be incorporated into our machine learning platform for production execution and monitoring, however, initial exploratory data analysis allows for more flexible experimentation to discover solutions to the business problems presented.</p><ul><li>
Work with key stakeholders within Research and Development as well as Operations, along with product management to assess the potential value and risks associated with business problems that have the potential to be solved using machine learning and Artificial Intelligence techniques.</li><li>
Develop an exploratory data analysis approach to verify the initial hypothesis associated with potential Artificial Intelligence/Machine Learning use cases.</li><li>
Document your approach, thinking and results in standard approaches to allow other data scientists to collaborate with you on this work.</li><li>
Prepare your final trained model and develop a validation test set for QA.</li><li>
Work with production operations to deploy your model into production and support them in monitoring model performance.</li><li>
Participate in other data science teams collaborating with your peers to support their projects.</li><li>
Participate in knowledge sharing sessions to bring new insights and technologies to the team.</li><li>
Participate in design sessions to continuously develop and improve the Cotiviti machine learning platform.</li><li>
Provide End to End value-based solutions, including data pipeline, model creation and application for end user consumption.</li><li>
Complete all responsibilities as outlined in the annual performance review and/or goal setting<b>.</b></li><li>
Complete all special projects and other duties as assigned.</li><li>
Must be able to perform duties with or without reasonable accommodation.</li></ul><div>
This 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 requirements of the job change.</div>
Qualifications:
<ul><li>Graduate degree in a quantitative discipline such as Computer Science/Engineering, Statistics, Operations Research covering Advanced Statistics, Machine learning and AI.</li><li>
Experience with the latest techniques in natural language processing including transformers, fine-tuning LLMs, measuring/benchmarking and deploying LLMs with tools such as HuggingFace, Langchain, Llama/Mistral and OpenAI, vector databases.</li><li>
7+ years of hands-on data science/AI experience, using typical machine learning and data science tools including pandas, scikit-learn, keras, nltk, and TensorFlow/PyTorch, GPU's.</li><li>
Experience building production-grade machine learning deployments on AWS, Azure, or GCP.</li><li>
Experience working with Apache Spark&trade; and large-scale distributed datasets.</li><li>
Experience communicating technical concepts to non-technical and technical audiences is a plus.</li><li>
Passion for collaboration, learn it all mindset and driving value with AI.</li></ul><div><b>
Mental Requirements:</b></div><ul><li>
Ability to work independently as well as collaborate as a team with a sense of urgency.</li><li>
Professional with ability to properly handle confidential information.</li><li>
Be value-driven, understand that success is based on the impact of your work rather than its complexity or the level of effort.</li><li>
Ability to handle multiple tasks, prioritize and meet deadlines.</li><li>
Ability to work within a matrixed organization.</li><li>
Proficiency in all required skills and competencies above.</li><li>
Communicating with others and teamwork.</li><li>
Assessing the accuracy, neatness, and thoroughness of the work assigned.</li></ul><div><b>
Physical Requirements and Working Conditions:</b></div><ul><li>
Flexibility to work with global teams as well geographically dispersed US based teams.</li><li>
Remaining in a stationary position, often standing or sitting for prolonged periods.</li><li>
Repeating motions that may include the wrists, hands and/or fingers.</li><li>
Must be able to provide high-speed internet access / connectivity and office setup and maintenance.</li><li>
Must be able to provide a dedicated, secure work area.</li></ul><div></div><div>
Base compensation ranges from $165,000 to $190,000 per year. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs. This role is eligible for discretionary bonus consideration.</div><div></div><div><br>
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.</div><div></div><div><br>
Since this job will be based remotely, all interviews will be conducted virtually.</div><div></div><div><br>
Date of posting: 11/10/2025</div><div>
Applications are assessed on a rolling basis. We anticipate that the application window will close on 02/10/2026, but the application window may change depending on the volume of applications received or close immediately if a qualified candidate is selected.</div><div></div><div><br>
#LI-Remote</div><div>
#Senior</div><div>
#LI-LL1</div></div>

Staff Generative AI Scientist

<div>Overview:
<div>
We are seeking an experienced Lead Software Engineer to design and lead the development of a scalable, high-performance FHIR Repository service capable of handling hundreds of terabytes of healthcare data. This system will form the foundation of our next-generation healthcare data platform &mdash; powering interoperability, analytics, and compliance across our product ecosystem.</div><div></div><div><br>
You will be responsible for the architecture, design, and implementation of core services that store, retrieve, and manage FHIR resources at massive scale. The ideal candidate combines deep technical expertise in database scalability, distributed systems, and Java engineering with strong leadership skills and a passion for solving real-world problems in healthcare data management.</div>
Responsibilities:
<ul><li>Architect and lead the design of scalable and fault-tolerant FHIR Repository supporting high-throughput operations.</li><li>
Define and implement data modeling, storage, and indexing strategies optimized for FHIR resource retrieval and updates at petabyte</li><li>
Drive performance, scalability, and cost-efficiency initiatives across the repository and related services.</li><li>
Partner with product management, cloud operations, and security teams to ensure compliance with HIPAA, and other healthcare data regulations.</li><li>
Evaluate and integrate cloud-native and database technologies (RDS, Aurora, PostgreSQL, sharding strategies, caching layers, etc.) to support growth.</li><li>
Lead proof-of-concepts and architectural prototypes to validate design approaches.</li><li>
Collaborate with cross-functional stakeholders to ensure the repository integrates seamlessly with APIs, analytics pipelines, and FHIR-based interoperability solutions.</li><li>
Complete all responsibilities as outlined in the annual performance review and/or goal setting<b>.</b></li><li>
Complete all special projects and other duties as assigned.</li><li>
Must be able to perform duties with or without reasonable accommodation.</li></ul><p>
This 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 requirements of the job change.</p>
Qualifications:
<ul><li>10+ years of experience in software engineering, with at least 3+ years in a technical leadership or architectural role.</li><li>
Proven expertise in Java, Spring Boot and related frameworks</li><li>
Strong experience with Relational databases (PostgreSQL, MySQL, or Aurora) including scaling, sharding, performance tuning, and distributed query optimization.</li><li>
Experience designing distributed systems, data pipelines, or large-scale storage services.</li><li>
Understanding of FHIR standards, RESTful APIs, and healthcare data interoperability principles.</li><li>
Knowledge of data partitioning, caching, and data-lifecycle management in high-volume systems.</li><li>
Strong foundation in cloud infrastructure (AWS preferred) including monitoring, autoscaling, and resiliency design</li><li>
Excellent analytical, problem-solving, and communication skills.</li></ul><div><b>
Preferred Qualifications</b></div><ul><li>
Experience working with healthcare data (FHIR, HL7, EDI).</li><li>
Experience with containerized and orchestrated environments (Docker, Kubernetes).</li><li>
Exposure to data governance and security requirements in healthcare (HIPAA, HITRUST).</li><li>
Experience mentoring engineers and influencing technical direction across teams.</li></ul><div><b>
Cognitive/Mental Requirements</b></div><ul><li>
Communicating with others to exchange information.
</li><li>Problem-solving and thinking critically.
</li><li>Completing tasks independently.
</li><li>Interpreting data.
</li><li>Making timely decisions in the context of a workflow.
</li><li>Maintaining focus.
</li><li>Assessing the accuracy, neatness, and thoroughness of the work assigned.
</li><li>Learning new tasks and completing tasks in situations that have a speed or productivity quota.</li><li>
Remembering and adhering to processes and protocols.
</li><li>Applying established protocols in a timely manner.</li></ul><div><b>
Physical Requirements and Working Conditions</b></div><ul><li>
Remaining in a stationary position, often standing or sitting for prolonged periods.
</li><li>Repeating motions that may include the wrists, hands, and/or fingers.
</li><li>Must be able to provide high-speed internet access / connectivity and office setup and maintenance.
</li><li>Must be able to provide a dedicated, secure work area.</li></ul><div><i>
Base compensation ranges from $122,000 to $170,000 per year. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs.</i></div><div></div><div><i><br>
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 </i><i>Careers page.</i></div><div></div><div><br>
Date of Posting: 11/7/2025.</div><div>
We anticipate that the application window will close on 12/7/2025, but the application window may change depending on the volume of applications received or close immediately if a qualified candidate is selected.</div><div></div><div><i><br>
Since this job will be based remotely, all interviews will be conducted virtually.</i></div><div></div><div><br>
#LI-REMOTE</div><div>
#senior</div></div><div></div>

Lead Software Engineer

<div>Overview:
<div>
At Cotiviti, we are custodians of data for our clients. Using their technical experience in ETL processes, Data Engineers ensure operational functions are occurring as expected. This includes but is not limited to managing data implementations, data integrations, data production, data quality, and data security.</div>
Responsibilities:
<ul><li>Create, maintain and execute intermediate to advanced Spark scripts for data management and data validation, and data integration</li><li>Create, maintain and execute basic to intermediate SQL scripts for data management and data validation.</li><li>Optimize the queries to improve the efficiency of daily tasks.</li><li>Perform data analysis and identify any issues.</li><li>Work with other groups such as Engineering team, DBA, Cloud ops, etc. to troubleshoot and resolve any environmental or network issues that impact your work. Extend your support to after &ndash; hours or weekends as needed.</li><li>Create and maintain data pipelines as needed</li><li>Validates the tasks results to ensure that all the requirements are met.</li><li>Adhere to all the industry level and organization level compliance rules and regulations to maintain data integrity.</li><li>Complete individual productivity tracking</li><li>Complete task assignments using department ticketing system within assigned deadline.</li><li>Achieve organizational and individual goals as identified in performance reviews and goal setting exercises.</li><li>Complete all special projects and other duties as assigned.</li><li>Must be able to perform duties with or without reasonable accommodation.</li></ul>
Qualifications:
<ul><li>Bachelor&rsquo;s degree in Computer Science, Information Technology or equivalent work experience.</li><li>3+ years of working knowledge of big data technologies (Spark, S3, Kafka, Ray, Hadoop, etc.)</li><li>3+ years of working knowledge of cloud (AWS, Azure, GCP, OCI etc.)</li><li>3+ years of working knowledge of RDBMS (Oracle, MS SQL, Vertica, etc.) and experience using SQL, PL/SQL or other data integration/ETL tools.</li><li>3+ years of data analysis. Preferably in the Healthcare industry of enrollment, medical claims and/or pharmacy claims.</li><li>Proficient in Microsoft Office Suite applications PowerPoint, Word, Excel and Outlook.</li><li>Flexible work schedule.</li><li>Experience with project management tools like JIRA.</li><li>Databricks and/or Snowflake environment familiarity a plus</li></ul><div></div><div><b><br>
Mental Requirements:</b></div><ul><li>Strong analytical skills</li><li>Excellent verbal, listening and written communication skills.</li><li>Ability to multitask and prioritize projects to meet scheduled deadlines and tight turnaround times.</li><li>Ability to work well independently or in a team environment.</li></ul><div></div><div><b><br>
Working Conditions and Physical Requirements:</b></div><ul><li>Remaining in a stationary position, often standing or sitting for prolonged periods.</li><li>Repeating motions that may include the wrists, hands and/or fingers.</li><li>Must be able to provide a dedicated, secure work area.</li><li>Must be able to provide high-speed internet access / connectivity and office setup and maintenance.</li></ul><div></div><div><b><br>
Pay Transparency:</b></div><div>
Base compensation ranges from $105,000.00 to $125,000.00. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs.</div><div></div><div><br>
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.</div><div></div><div><br>
Since this job will be based remotely, all interviews will be conducted virtually.</div><div></div><div><br>
Date of posting: 11/10/2025</div><div>
Applications are assessed on a rolling basis. We anticipate that the application window will close on 02/10/2026, but the application window may change depending on the volume of applications received or close immediately if a qualified candidate is selected.</div><div></div><div><br>
#LI-LL1</div><div>
#LI-remote</div><div>
#senior</div></div><div></div>

Data Engineer AI

<div>Overview:
<div>
The Content Analyst II is a key member of the clinical operations and content team responsible for the research, quality assurance, and opportunity analysis associated with new medical policies. In addition, this position will be responsible for review and analysis of current medical policies and assisting in the research necessary to define additional logic and algorithms to expand the Cotiviti payment policy library. Specific focus for this role will be on our Medicaid team.</div>
Responsibilities:
<ul><li>Provide coding and industry expertise to help create and maintain clinical coding edits.</li><li>
Responsible for writing business logic for new rules and enhancements by translating industry references into Cotiviti policy.</li><li>
Reviews and identifies changes to medical policies in order to maintain an accurate and current medical policy library.</li><li>
Work with the client teams to provide coding and clinical expertise for customer and provider inquiries, questions, challenges, or appeals to clinical rules.</li><li>
Assumes full ownership and accountability for assigned medical policies.</li><li>
Performs multi-faceted analytics for data and report analysis with minimal direction.</li><li>
Mentor and train new staff.</li><li>
Performs QA of policy reviews, logic revisions, and research requests performed by others to ensure accuracy.</li><li>
Maintains current knowledge-base of industry and Cotiviti content, best practices, applications, procedures, and policies.</li></ul>
Qualifications:
<ul><li>One of the following degrees is required:<ul><li>
Active professional license as a Registered Nurse (BSN preferred).</li><li>
Pharmacist (BSPharm or PharmD).</li><li>
Bachelor&rsquo;s degree (healthcare-related field preferred).</li><li>
Offshore Medical Degrees (MBBS or higher).</li></ul></li><li>
Professional certification (RHIA, RHIT, CPC, CPC-H, CPC-P, or CCS-P) preferred or willing to pass certification exam within one year of employment.</li><li>
Minimum of 5 years of experience in a clinical setting as a nurse, pharmacist, or physician OR minimum of 6 years of clinical coding experience, preferably in a payer setting.</li><li>
Minimum of 3 years of experience in internet-based research as it relates to codes (CPT, HCPCS, ICD, or NDC).</li><li>
Knowledge of Medicaid guidelines highly preferred.</li><li>
Familiarity with claims payment and reimbursement methodologies as well as medical policy rules and edits.</li><li>
Ability to analyze complex data and synthesize it for customer and internal consumption.</li><li>
Ability to work well both independently and collaboratively, in a fast-paced and demanding environment.</li><li>
Effective at managing timelines and multiple projects with high accuracy and attention to detail.</li><li>
Strong analytical, critical thinking, and problem-solving skills.</li><li>
Proficiency in Microsoft Office suite.</li><li>
Excellent interpersonal, verbal, and written communication skills.</li></ul><div><b>
Mental Requirements:</b></div><ul><li>
Communicating with others to exchange information.</li><li>
Assessing the accuracy, neatness, and thoroughness of the work assigned.</li></ul><div><b>
Physical Requirements and Working Conditions:</b></div><ul><li>
Remaining in a stationary position, often standing or sitting for prolonged periods.</li><li>
Repeating motions that may include the wrists, hands, and/or fingers.</li><li>
Must be able to provide a dedicated, secure work area.</li><li>
Must be able to provide high-speed internet access/connectivity and office setup and maintenance.</li><li>
No adverse environmental conditions are expected.</li><li>
After hours and/or weekend work required where necessary for major deliverables/deadlines (not consistent).</li></ul><div>
Base compensation ranges from $72,000 to $100,000 per year. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs.</div><div></div><div><br>
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.</div><div></div><div><br>
Date of posting: 11/6/2025</div><div>
Applications are assessed on a rolling basis. We anticipate that the application window will close on 12/31/2025, but the application window may change depending on the volume of applications received or close immediately if a qualified candidate is selected.</div><div>
#LI-JB1</div><div>
#LI-Remote</div><div>
#senior</div></div><div></div>

Content Analyst II (Medicaid)

<div>Overview:
<div>
Cotiviti is seeking a Data Scientist to lead the development of advanced classification and predictive systems for healthcare risk adjustment and ICD-10 code classification. This role will focus on building intelligent NLP systems that analyze clinical charts and encounters to accurately identify and classify ICD-10 codes through sophisticated pattern recognition, machine learning, and natural language processing techniques.</div>
Responsibilities:
<ul><li>Lead development of NLP-based classification systems for ICD-10 code identification from clinical charts and encounters
</li><li>Design and implement deep learning models using PyTorch and transformer architectures for medical text analysis
</li><li>Build and optimize machine learning models for accurate risk adjustment coding and HCC classification
</li><li>Develop decision support systems for automated ICD-10 code suggestion and validation
</li><li>Create and maintain feature engineering pipelines for clinical text processing and model training
</li></ul><div>&bull; Implement model evaluation metrics and performance optimization strategies for healthcare coding accuracy &bull; Produce comprehensive technical documentation and training materials for NLP models
</div><ul><li>Conduct system health checks and performance monitoring for deployed coding models
</li><li>Collaborate with engineering teams to integrate ML/NLP solutions into production systems
</li><li>Provide technical guidance on statistical modeling, transformer architectures, and algorithm selection
</li><li>Support data pipeline design and implementation for clinical text analytical workflows
</li><li>Participate in code reviews and maintain high standards for code quality
</li><li>Experience with distributed computing frameworks and big data technologies for processing large volumes of clinical data
</li><li>Mentor junior scientists and analysts in machine learning, NLP, and artificial intelligence best practices
</li><li>Track record of using assistive AI technology to improve quality and efficiency of modeling and analytics
</li><li>Complete all responsibilities as outlined in the annual performance review and/or goal setting. <b>Required</b>
</li><li>Complete all special projects and other duties as assigned. <b>Required</b>
</li><li>Must be able to perform duties with or without reasonable accommodation. <b>Required</b></li></ul>
Qualifications:
<ul><li>Bachelor's degree in Computer Science, Statistics, Mathematics, Data Science, or related field; Master's in Data Science or related field preferred</li><li>3+ years of experience in machine learning and AI with focus on NLP, classification, and predictive systems</li><li>Strong expertise in PyTorch and transformer architectures (BERT, RoBERTa, etc.) for text classification</li><li>Advanced Python programming skills with experience in NLP frameworks and libraries</li><li>Experience with healthcare claims data, clinical text processing, and ICD-10 coding systems preferred</li><li>Knowledge of risk adjustment methodologies and HCC (Hierarchical Condition Categories) coding</li><li>Experience with feature engineering techniques for clinical text and model evaluation methodologies</li><li>Experience with model deployment and monitoring in production environments</li><li>Understanding of data quality frameworks and error detection methodologies for healthcare coding</li><li>Strong analytical and problem-solving skills with focus on clinical data challenges</li><li>Excellent communication skills with ability to explain technical NLP concepts clearly</li><li>Experience with version control systems and collaborative development practices</li><li>Expertise with SQL and data manipulation tools for healthcare datasets.</li></ul></div>

Data Scientist