Lead Sales Solutions Consultant

Overview

A Lead Solution Consultant will play a pivotal role in driving Cotiviti ’s growth by combining deep technical expertise with strong pre-sales acumen across the healthcare payer landscape. This is a client-facing role requiring the ability to lead technical discovery, perform detailed assessments, and design solution architectures aligned to payer business and IT environments.

The role will support clients across Cotiviti ’s Health Enablement, Interoperability, and Payment Integrity solutions, while developing the ability to position integrated, cross-product solutions. This role requires hands-on experience with payer systems, data flows, and regulatory frameworks, along with the ability to translate complex technical concepts into business value. While expertise will span the full Cotiviti portfolio, role may develop deeper specialization in areas such as Payment Integrity.
Responsibilities
Technical Expertise & Domain Knowledge

- Serve as a technical subject matter expert within assigned solution domains, with deep understanding of healthcare payer operations, core administrative systems (e.g., claims, enrollment, prior auth), and data ecosystems

- Contribute to solution designs and recommend technical approaches, including integrations, data flows, and interoperability patterns

- Stay current on payer industry trends, regulatory mandates (CMS, interoperability rules, prior auth), and competitive landscape

- Good working knowledge of claims, membership, payment integrity, risk adjustment, quality measures and provider mgmt. workflows

Discovery, Solutioning & Architecture

- Lead technical discovery sessions, current-state assessments, and architecture discussions with payer clients to identify gaps and solution opportunities

- Support pre-sales engagements end-to-end, including solutioning, whiteboarding, technical validation, and deal strategy in partnership with sales and senior team members

Pre-Sales Execution & Deal Support

- Develop and deliver high-impact demos, technical presentations, and tailored solution proposals aligned to client-specific use cases

- Support complex RFP/RFI responses with detailed technical, architectural, and functional inputs

- Lead or support proof-of-concepts, pilots, and technical workshops to validate solution fit and accelerate deal closure

Account Alignment and Cross Functional Collaboration

- Build and maintain account-specific institutional knowledge, enabling stronger cross-sell and upsell positioning across business units

- Partner closely with sales, product, and delivery teams to ensure feasible, scalable, and differentiated solutions

- Provide customer feedback and requirements to support roadmap planning

- 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.
Qualifications

- Bachelor’s degree in healthcare, business, computer science, or a related field

- 8+ years of experience in healthcare payer technology, solution consulting, or solution engineering in a client-facing pre-sales role

- Strong hands-on experience within the payer ecosystem, including core administrative platforms (e.g., claims, enrollment, prior authorization), data integration, and operational workflows

- Proven ability to lead technical pre-sales engagements, including discovery, solution design, architecture discussions, and technical validation

- Understanding of healthcare interoperability standards and technologies, including A