Content Analyst II - Drug and Biological Policy

## About the Role The Content Analyst II position at Cotiviti is a key component of the company's clinical operations and content team. This role is centered around the research, quality assurance, and maintenance of existing drug and biological policies. As a Content Analyst II, you will be expected to define additional logic and algorithms to expand the policy library, ultimately adding value for clients who implement these policies. The day-to-day responsibilities of this position involve a deep understanding of clinical coding edits, the ability to write business logic for new rules and enhancements, and the capacity to translate industry references into Cotiviti policy. You will be working closely with client teams to provide coding and clinical expertise for customer inquiries, questions, challenges, or appeals of clinical rules. This role requires full ownership and accountability for assigned policies, as well as the ability to mentor and train new team members.

## What You Will Do - Provide coding and industry expertise to help create and maintain clinical coding edits.

• Write business logic for new rules and enhancements by translating industry references into Cotiviti policy.
• Review and identify changes to drug and biological policies to maintain an accurate and current medical policy library.
• Work with client teams to provide coding and clinical expertise for customer inquiries, questions, challenges, or appeals of clinical rules.
• Assume full ownership and accountability for assigned drug and biological policies.
• Help mentor and train new team members.
• Assist other team members when there are questions regarding policy reviews, logic revisions, and research requests performed by others to ensure accuracy.
• Maintain current knowledge of industry and Cotiviti content, best practices, applications, procedures, and policies.
• Complete all responsibilities as outlined in the annual performance review and/or goal setting.
• Complete all special projects and other duties as assigned.

## What We Are Looking For - Active professional license as a Pharmacist (BSPharm or PharmD).

• Professional certification (AHIMA or AAPC) preferred or willingness to pass certification exam within one year of employment.
• 5+ years of experience as a pharmacist with at least three years of experience in a specialty, clinical, or bedside setting.
• At least three years’ experience in medical policy or prior authorization in a health plan setting preferred.
• Experience in internet-based research as it relates to drug information and coding (CPT, HCPCS, ICD, or NDC).
• Familiarity with claims payment and reimbursement methodologies.
• Ability to analyze data and synthesize it for internal consumption.
• Ability to work well both independently and collaboratively.
• Effective at managing timelines and multiple projects with high accuracy and attention to detail.
• Strong analytical, critical thinking, and problem-solving skills.
• Proficiency in Microsoft Office suite, with preferred knowledge of Excel, Pivot table, functions to analyze data.

## Nice to Have - Experience working in a remote setting with a proven ability to manage time effectively and meet deadlines.

• Knowledge of project management tools and software.
• Certification in a related field beyond the required Pharmacist license.
• Experience with data analysis and reporting software.

## Benefits and Perks - Competitive salary.

• Comprehensive health insurance package.
• Retirement savings plan.
• Paid time off and holidays.
• Flexible working hours and remote work arrangement.
• Opportunities for professional development and growth.
• Access to cutting-edge technology and tools.
• Collaborative and dynamic work environment.
• Recognition and reward for outstanding performance.

- Ensure your resume highlights specific experience with Excel, particularly in data analysis and Pivot tables, as this is a key skill for the role.

• Prepare examples of times when you had to manage multiple projects simultaneously and prioritize tasks to meet deadlines.
• Familiarize yourself with Cotiviti's values and mission to demonstrate your understanding of the company culture during the interview.
• Be ready to discuss your experience with medical policy and your ability to translate industry references into actionable policy changes.
• Consider creating a portfolio or preparing case studies that showcase your analytical and problem-solving skills, especially in relation to drug and biological policy.
• When negotiating salary, research the market rate for similar positions in the healthcare industry to make an informed argument for your worth.
• Pay close attention to the company's expectations for remote work, including time zone flexibility and after-hours work requirements, to ensure it aligns with your personal and professional needs.