Product Manager - Fraud, Waste & Abuse

Cotiviti • Remote,

1d • $103,000 - $128,000 • Remote

About The Position

The Product Manager – Fraud, Waste, and Abuse (FWA) is responsible for driving the strategy, development, and lifecycle management of Cotiviti’s FWA product suite, including advanced analytics-driven solutions designed to identify and prevent improper healthcare billing. This role works at the intersection of product, analytics, operations, and client engagement to deliver high-impact solutions that improve payment integrity outcomes for healthcare payers. The Product Manager partners closely with cross-functional teams including R&D, data science, operations, implementations, and product marketing to define product vision, prioritize roadmap investments, and ensure successful delivery of scalable, client-ready solutions. This includes translating complex market and client needs into actionable product requirements, supporting go-to-market activities, and ensuring solutions are aligned with evolving regulatory and industry demands. The role requires strong domain expertise in healthcare payment integrity and/or fraud, waste, and abuse, along with experience working in analytics-driven or workflow-based applications. Products within this space leverage rules-based detection, machine learning models, and integrated case management workflows to identify suspect provider behavior, support investigations, and drive financial recoveries. Success in this role requires the ability to balance strategic thinking with execution, manage competing priorities in a fast-paced environment, and influence stakeholders across a highly matrixed organization. The Product Manager will play a key role in advancing Cotiviti’s broader FWA strategy, including the evolution toward integrated end-to-end solutions that combine prepay and postpay fraud detection capabilities into a unified platform experience.

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.
• Technical background, with experience in software development.
• Proven ability to influence cross-functional teams without formal authority.
• Proficiency in Microsoft Excel, Microsoft Access, Database interaction capabilities.
• Excellent communication and stakeholder management abilities.
• Able to translate regulatory/clinical requirements into technical solutions and explain technical concepts to non-technical audiences.
• 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.

Nice To Haves

• 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

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.
• 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.

Benefits

• medical, dental, vision, disability, and life insurance coverage
• 401(k) savings plans
• paid family leave
• 9 paid holidays per year
• 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti

What This Job Offers

• Job Type: Full-time
• Career Level: Senior