Product Manager - Fraud, Waste & Abuse

Cotiviti is a company focused on healthcare analytics, and they are seeking a Product Manager for their Fraud, Waste, and Abuse (FWA) product suite. This role involves driving product strategy, collaborating with cross-functional teams, and delivering solutions to improve payment integrity outcomes for healthcare payers.

Responsibilities:

• Define the product strategy and roadmap
• Deliver product market requirements documents with prioritized features and corresponding justifications
• Work with external third parties to assess partnerships and licensing opportunities
• Be an expert with respect to the competition
• Develop the core positioning and messaging for the product
• Perform product demos to customers
• Collaborate with Marketing to develop sales tools
• Propose an overall budget to ensure success
• Briefly train the sales force at quarterly sales meetings
• Act as a leader within the company
• Collaborate with analytics and AI/ML teams to enhance product capabilities, including rules-based detection, provider scoring, and advanced data insights that identify aberrant billing behaviors
• Balance competing priorities across stakeholders, manage trade-offs, and ensure alignment between strategic goals and execution
• Contribute to the evolution of integrated offerings (e.g., prepay and postpay solutions) to deliver a cohesive, end-to-end fraud detection and payment integrity platform
• Provide domain expertise in fraud, waste, and abuse workflows, including provider investigations, case management, and recovery processes
• Hire, develop, coach, lead and retain top-tier talent, with a focus on building and improving a team and culture that is able to assist in employing best in class practices to support and drive high levels of internal and external customer satisfaction
• 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

Requirements:

• Bachelor's degree in Business, Computer Science, or other field demonstrating technical expertise
• 3-5+ years of Product Management experience required
• Strong analytical and product management skills required, including a thorough understanding of how to interpret client business needs and translate them into application and operational requirements
• Demonstrated success defining and launching web based services and products
• Excellent verbal and written communication skills and the ability to interact professionally with a diverse group, executives, managers, and subject matter experts
• Proven ability to influence cross-functional teams without formal authority
• Proficiency in Microsoft Excel, Microsoft Access, Database interaction capabilities
• Strong problem-solving mindset and a track record of driving initiatives from concept to implementation
• Leadership and mentorship capabilities are essential – this role will guide teams and represent Cotiviti's interoperability expertise both internally and externally, so the candidate should be comfortable taking initiative, 'leading without authority' when required, and mentoring others
• Previous experience in healthcare FWA preferred
• Experience with Kanban preferred
• Experience with AI and/or Machine Learning initiatives preferred
• Medicare Advantage or other healthcare experience preferred
• National Heath Care Anti-Fraud Association - Certified Accredited Health Care Fraud Investigator preferred