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Cotiviti
Cotiviti
5,001 – 10,000 Employees
H1B Visa SponsorConsultingHealthcareLogistics
Cotiviti is a healthcare technology and analytics company that helps health plans, government agencies, and healthcare providers improve payment accuracy, operational performance, and care quality. Its data-driven solutions support risk adjustment, payment policy management, and member engagement, turning complex healthcare information into insights that can strengthen both financial and clinical outcomes across the healthcare ecosystem.
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VP Sales, Pharmacy Claim Editing Solutions – U.S. Remote

Lead new-logo sales for Cotiviti’s pharmacy claim editing and payment accuracy solutions across the United States. Sell complex healthcare software and services to health plans, TPAs, PBMs, and self-funded employers.

USUnited States
$145,000 – $190,000 / year
RemoteFull-timeLeadEnglish RequiredSales

Description

  • Create and execute a new-business sales strategy for Cotiviti’s Pharmacy Claim Editing and Accuracy solutions across an assigned U.S. territory.
  • Identify, qualify, and close opportunities with health plans, payer-owned PBMs, TPAs, and self-funded plan administrators.
  • Build senior-level relationships across health plan, TPA, pharmacy operations, claims, payment integrity, compliance, finance, procurement, and benefits functions.
  • Manage complex sales cycles involving pharmacy claim accuracy, payment integrity, ROI, savings validation, performance guarantees, and software-plus-services agreements.
  • Create territory and account plans informed by pharmacy market conditions, customer priorities, and competitive factors.
  • Partner with Product, Clinical Pharmacy SMEs, Legal, and Implementation teams on solution positioning, executive business cases, RFPs, procurement, and value propositions.
  • Track competitor activity, pricing movements, and market developments in pharmacy claim accuracy and claims auditing.
  • Represent Cotiviti at pharmacy conferences, industry events, and executive briefings.
  • Maintain accurate CRM records, pipeline oversight, forecasts, and opportunity tracking.
  • Keep sales leadership informed about pipeline health, forecast exposure, market intelligence, and customer feedback.
  • Conduct sales activities in accordance with Cotiviti policies, compliance requirements, contracting standards, budgets, and performance plans.
  • Assess market conditions, competitive dynamics, customer needs, and trends, then recommend ways to pursue opportunities.
  • Suggest enhancements to sales and service delivery programs and processes.
  • Handle special projects and other assigned responsibilities.

Requirements

  • Bachelor’s degree or equivalent relevant experience in healthcare, business, marketing, or a related discipline.
  • 12–15 years of enterprise healthcare hunting sales experience.
  • At least 5 years selling to health plans, TPAs, or pharmacy benefit organizations; 7 or more years preferred.
  • Demonstrated success selling pharmacy claim editing, payment accuracy, utilization management, or related prescription-drug industry services.
  • Sales experience with at least two segments, such as commercial health plans, Medicare Advantage or Part D plans, Medicaid MCOs, payer-owned PBMs, TPAs, or self-funded employers.
  • Track record of closing contracts valued from hundreds of thousands to multiple millions of dollars.
  • Extensive experience engaging C-suite, SVP, and VP decision-makers within payer and TPA organizations.
  • Strong knowledge of pharmacy claims processing and adjudication across retail, mail-order, and specialty channels.
  • Understanding of NCPDP standards, benefit design, clinical edits, formulary management, and AWP, WAC, MAC, and NADAC pricing methods.
  • Familiarity with Medicaid pharmacy programs and commercial pharmacy benefits.
  • Familiarity with Medicare Part D payment integrity, CMS compliance, and rebate/DIR dynamics.
  • Understanding of self-funded and ASO pharmacy benefit structures, TPA operating models, and CAA fiduciary and transparency obligations.
  • An established executive network within health plan or TPA pharmacy organizations is strongly preferred.
  • Expertise in enterprise sales practices and structured closing methodologies.
  • Strong financial judgment with the ability to explain ROI, realized savings, and value-based pricing.
  • Highly organized, self-motivated, and effective in a remote, fast-growing environment.
  • Excellent verbal, written, and presentation abilities for executive audiences.
  • Ability to coordinate complex pursuits and internal deal teams.
  • Experience with Salesforce, Microsoft Dynamics, or a comparable CRM.
  • Willingness and ability to travel 40–60%.
  • Strong analytical, research, prospecting, interpersonal, oral, and written communication skills.
  • Ability to perform daily responsibilities with minimal or no direct supervision.
  • Ability to maintain a dedicated, secure workspace.
  • Ability to supply high-speed internet connectivity and maintain the required office setup.

Benefits

  • Eligible for commission compensation.
  • Medical, dental, vision, disability, and life insurance coverage.
  • 401(k) savings plan.
  • Paid family leave.
  • Nine paid holidays annually.
  • 17–27 days of paid time off per year, based on level and length of service.
  • Remote work arrangement.
  • Virtual interview process.
  • Team member provides a dedicated secure workspace, high-speed internet, and office setup and maintenance.

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