The Director, Audit Operations (Retail) position is responsible for providing leadership and management for Multiple accounts or significant audit projects. Oversee all audit activities for assigned accounts to maximize valid claim identification and overpayment recoveries, meet contractual commitments, and deliver customer satisfaction consistent with established operating practices and audit procedures. Additionally, the Director, Audit Operations Retail should seek opportunities to expand Cotiviti’s audit scope and deliver value-add services that are consistent with client initiatives. This will be accomplished through effective audit operations management, quality and service assurance, and effective people management and development. Relationship management with our client to understand their business. Meet with clients to discuss solutions.

• Directs the successful delivery of audit services to the client by managing the team(s) assigned to the engagement and providing leadership and direction and ensuring that the client's needs and expectations are met and exceeded. Develops and implements key metrics to drive performance in quality and productivity and to ensure that the customer experience is consistent and satisfactory across all phases of the audit.
• Reviews audit progress against established metrics and direct activities as needed to ensure achievement of business goals and customer expectations. Ensures effective coordination with Business Optimization and other support functions to achieve audit goals. Demonstrates awareness and sensitivity to the needs of the client, the needs of the audit team, and the profitability of the audit engagement.
• Continually work to improve efficiency, productivity and reduce operational costs while providing 100% compliance with customer contract and company policies.
• Supports the continuous development of innovative solutions and audit concepts with audit team. Works to optimize audit processes and efficiencies.
• Strategically navigates through customer issues and conflict, including direct communication with customers to achieve mutually accepted resolution. Provides assistance and removes barriers as needed to identify opportunities for process improvements. Serves as top escalation point to resolve any customer issues that are roadblocks to customer satisfaction. Leads the implementation of all appropriate actions by other leaders and teams to understand and resolve issue and ensures follow through until closure and complete customer satisfaction.
• Ensures the audit team is looking at all possible claim categories and claim types and is using all available proprietary software, reports and IT resources to conduct their audits. Collaborates with SAM to achieve growth opportunities within existing and potential clients.
• Ensures compliance all HIPAA regulations regarding the safe-guarding of Protected Health Information (PHI) and communicate to all associates involved in the audit engagement.
• Partners with the client and sales team on renewals and work through any RFP process by identifying gaps in current contract in place and understanding customer needs in order to successfully renew the contract. Performs customer needs and service analysis, makes recommendations on appropriate pricing structure and contract requirements, and contribute to RFP responses. Facilitates contract terminations or scope changes including identifying reason for change, defining possible solutions to customer issues to lead to retention, negotiating account transition procedures and prices.
• Meets regularly with audit and audit support managers to ensure appropriate staffing levels and to plan and organize workloads and staff assignments according to the needs of the audit.
• Consistent with good people management practices and company values. Provides managerial leadership and direct the selection, supervision, evaluation and development of staff. Sets objectives and conducts performance reviews for direct reports and oversees the remaining evaluations indirect team members.
• Follow established processes for training and career progression to enable revenue growth and auditor and support staff development and engagement. Promotes & participates in knowledge sharing activities such as best practices, benchmarking, whitepapers and IT tools enhancement. Ensures that all levels of staff are properly trained on policies, procedures and best practices and that proper training, education and required certifications are maintained as required.
• 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.  

• Bachelor’s degree in business or finance; or an equivalent combination of experience and education.  
• Minimum 10 years of experience in Retail Recovery Audit Operations, with experience managing teams and processes across multiple clients.
• Experience in accounting, finance, accounts payable, merchandising, buying, or audit required.
• Strong working knowledge and understanding of retail industries required.
• Solid financial acumen and understanding of budget, forecast and workforce planning required.
• Must possess both strong analytical skills, and the ability to think strategically. 
• Must have strong presentation skills with both internal and external clients
• Must have proven ability to build strong client relationships.
• Excellent verbal and written communication skills required.
• Advanced computer skills in Excel are required.
• Advanced computer skills in Access preferred.
• Prior experience with direct client contact (account management, audit, sales, etc.) required.
• Must be comfortable working with c-suite level executives.
• Willing to travel (potentially Internationally) to clients, Cotiviti offices, conferences, training, etc. as required.

Base compensation ranges from $175,000 to $225,000 per year. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs. This role is eligible for discretionary bonus consideration.

Cotiviti offers team members a competitive benefits package to address a wide range of personal and family needs, including medical, dental, vision, disability, and life insurance coverage, 401(k) savings plans, paid family leave, 9 paid holidays per year, and 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti. For information about our benefits package, please refer to our Careers page.

Date of posting: 6/18/2025

Applications are assessed on a rolling basis. We anticipate that the application window will close on 8/18/2025, but the application window may change depending on the volume of applications received or close immediately if a qualified candidate is selected.

#LI-Remote
#LI-JB1
#director