Cotiviti Overview and Leadership Cotiviti stands as a leading healthcare technology and analytics company with over 25 years of experience optimizing healthcare outcomes [3]. Specializing in payment accuracy, risk adjustment, and quality improvement solutions, the company serves the top 25 health plans in the United States [4]. Based in South Jordan, Utah [6], and owned by Veritas Capital, Cotiviti operates under the leadership of:
- Dr. Emad Rizk - President and CEO [1]
- Felix Morgan - Chief Financial Officer, bringing over 20 years of financial and operational leadership experience [1]
Technology and Analytics Capabilities At the heart of Cotiviti's operations is the Caspian Clarity platform, which processes thousands of unique member and provider data types across financial and clinical domains [5]. The platform now represents approximately 40% of Americans with health insurance coverage [1], enabling comprehensive healthcare analytics across:
- Payment accuracy and fraud prevention
- Risk adjustment services
- Quality improvement programs
- Population health management [8]
Federal Healthcare Presence Cotiviti has built a strong federal healthcare presence through its 18-year partnership with the Department of Veterans Affairs [3]. As the designated Recovery Audit Contractor for the VHA's Office of Community Care, the company has achieved remarkable results:
- Over $9 billion returned to VA's Medical Collection Fund
- Comprehensive payment accuracy optimization
- Robust program integrity and claims validation services [1]
Quality Management and Security Framework Cotiviti maintains rigorous quality management standards and security protocols, demonstrated through multiple industry certifications:
- HEDIS® Certified Measures status for 24 consecutive years [1]
- NCQA Certified Measures™ status for 21 consecutive years [5]
- CMMI Level 3 certification for IT Infrastructure [1]
- HITRUST CSF® certification for core healthcare solutions [4]
Innovation and Recognition The company's commitment to innovation is exemplified by its COVID-19 Outbreak Tracker, which achieved over 80% accuracy in predicting infection hotspots [1]. Recent recognition includes:
- Stevie® Award in the 2021 American Business Awards®
- Fast Company 2021 World Changing Ideas Award
- Forbes recognition for pandemic response
- Elite CMMI Level 3 designation, making it one of only thirty U.S. companies with this distinction [3]
Industry Leadership and Affiliations Cotiviti maintains strong industry connections through key memberships:
- Affiliate Member of America's Health Insurance Plans
- Premier Supporting Member of National Health Care Anti-Fraud Association
- Platinum Sponsor of Resource Initiative & Society for Education
- Member of California Association of Health Plans
- Affiliate Member of Texas Association of Health Plans [1]