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Product Director - Fraud, Waste & Abuse

Company: Cotiviti Inc.
Location: Atlanta
Posted on: February 25, 2021

Job Description:

If you are a job seeker with a disability and require a reasonable accommodation to apply for one of our jobs, you will find the contact information to request the appropriate accommodation by visiting the following page: Please note:--For the safety of our employees and those considering employment with Cotiviti, we are currently conducting all interviews virtually. In addition, the majority of the Cotiviti team is currently working remotely, and we are onboarding new hires remotely as well. As we monitor the pandemic, these arrangements may change and we will update accordingly. Cotiviti healthcare fraud detection is entering a new level to service our commercial and government healthcare payers to identify and prevent abusive or fraudulent billing of medical and pharmacy claims. The Product Director of Fraud, Waste and Abuse, will drive product strategy within the Cotiviti Fraud, Waste and Abuse solution suite. Working closely with business unit operations and technology team this individual will lead the design and development to advance Cotiviti healthcare fraud detection and prevention products and services.-- This individual will have subject matter expertise on system design, workflow, policy development, data mining, and familiarity with Surveillance Intelligence Units (SIU) policies and procedures.-- Reporting to the VP of Product, Prospective Payment, this individual will have years of background working to understand the ever changing landscape in healthcare fraud, waste and abuse. We are looking for an individual who is interested in taking their knowledge and experience to build prospective payment solutions, not just reacting to retrospective fraudulent and abusive behavior. Experience with analytical as well as workflow applications will further enhance this individual's ability to develop high-impact solutions. The successful candidate will demonstrate a unique blend of leadership, product and market domain expertise, business acumen, creativity, business judgment, entrepreneurial spirit, industry knowledge, and analytical knowledge. Responsibilities Key responsibilities: The Product Director will lead cross-sectional, matrixed teams in support of specific products in the Cotiviti portfolio. Key responsibilities include:

  • Vision: Sets vision for product(s). Ensures customer focus by communicating and building rapport with customers as required and ensuring the "voice of the customer" is reflected in work processes. Roadmap creation and presentation to internal operating units.
  • Market discovery: Leads market-facing activities to best understand, capture, and translate market needs into innovative solutions. This includes managing ideas through the innovation funnel and successfully developing business cases and associated materials to drive investment decisions.
  • Launch planning: Develops and maintains product launch plans for new and existing products. Supports the development of product value propositions, differentiators, and other product requirements. Conducts research as appropriate to further understand the competitive profile for the segment, and opportunities for growth.
  • Delivery: Partners with other product managers to ensure appropriate and viable end-to-end solution delivery. Establishes and maintains cross-functional relationships within Cotiviti in order to facilitate the delivery of product launch plans and materials.
  • Leadership: Mentors, leads, and influences others in the organization to be market-driven for all business decisions. Closely collaborates with marketing team to ensure market opportunities and needs are reflected in product plans and requirements (both go to market and engineering).
  • Growth: Plays an active role in the sales process supporting product collateral development in conjunction with marketing; and other activities as required.
  • Pricing: Partners with finance and VP to create pricing models consistent with Cotiviti's strategy, and identify which levers to pull within build-buy-partner models to successfully deliver solutions in the market.
  • Metrics-driven management: Holds self and others accountable for delivering on key metrics to ensure product success in the market.
  • Quality: Works closely with technology, operations, and senior leadership to ensure releases are of the highest quality, and that his/her team can demonstrate progress against quality goals through clear metrics. Requirements:--
    • Bachelor's degree in business, computer science, information technology, or equivalent Master's preferred.
    • 10 years relevant experience in product management with software solutions.
    • Minimum 5 years' experience, with increasing levels of responsibility and oversight, within a healthcare IT vendor or comparable experience working for a payer or provider.
    • Subject matter expertise in Fraud, Waste, and Abuse.
    • Referenceable experience working with customers to envision and deliver software products.
    • Proven track record of successful product launches.
    • Experience with software development lifecycle, Agile methodologies.
    • Hands on experience with analytics and reporting, and data discovery.
    • The demonstrated experience and energy to excel in a complex and ever-changing environment, coupled with the poise and ability to act calmly in high-pressure, high-stress situations.
    • Excellent written and verbal communication skills, and ability to influence at all levels in the organization.
    • Relevant certifications preferred, such as CPC-P, CPMA, AHFI, etc.
    • Analytic, creative, and business focused leadership.
    • Willingness to travel to client or conference sites, 25%. Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)

Keywords: Cotiviti Inc., Atlanta , Product Director - Fraud, Waste & Abuse, Executive , Atlanta, Georgia

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