Cotiviti
Cotiviti
Cotiviti — денсаулық сақтау жоспарларына, мемлекеттік органдарға және медициналық қызмет көрсетушілерге төлемдердің дәлдігін, операциялық тиімділікті және медициналық көмектің сапасын арттыруға көмектесетін денсаулық сақтау технологиялары мен аналитика компаниясы. Оның деректерге негізделген шешімдері тәуекелдерді түзетуді, төлем саясатын басқаруды және қызмет алушылармен өзара іс-қимылды қолдай отырып, күрделі денсаулық сақтау ақпаратын құнды түсініктерге айналдырады. Бұл бүкіл денсаулық сақтау экожүйесінде қаржылық және клиникалық нәтижелерді жақсартуға мүмкіндік береді.

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.

Сипаттама

  • 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.

Талаптар

  • 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.

Артықшылықтар

  • 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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