Rachael_Jones

Rachael N. Jones

Senior Vice President, Performance Analytics & Quality, Cotiviti

Rachael Jones is the Senior Vice President, Performance Analytics & Quality at Cotiviti,
a leading solutions and analytics company that leverages unparalleled clinical and
financial datasets to deliver deep insight into the performance of the healthcare system.
These insights uncover new opportunities for healthcare organizations to collaborate to
improve their financial performance, reduce inefficiency, and improve healthcare quality.
In her role, she has accountability for business unit strategy, product vision, team, and
market impact for one of the company’s high-growth verticals, Performance Analytics &
Quality, which allows health plans to move from simply reporting quality measures to
driving the purchase, delivery, and utilization of higher value healthcare.
Prior to her current role, she was Vice President, Growth & Account Management for
Anthem’s Diversified Business Group (DBG) division which is focused on delivering
whole person care to radically transform the healthcare industry. She led a team that
leveraged the commercial experience of Anthem, the nation’s largest Blue health plan,
bringing strategic solutions to health plans across the country. Focusing on a range of
health plan needs, these solutions offer critical insights on how to personalize and
integrate care for those with complex and chronic conditions.
Backed by nearly two decades of health care and technology experience, Rachael is
well recognized for her expertise in solution sales, delivery and product management,
and as an innovator in cost-of-care and provider reimbursement strategies. Prior to her
current role, she had financial oversight of payment innovation programs, as well as
analytics product development that drove the shift from volume to value-based payment
models.
Within the healthcare industry, Rachael has also held leadership roles at Healthfirst,
LLC, where she served as Assistant Vice President of Financial Analysis, overseeing
regulatory reporting, shared risk/ACO performance analysis and as a leader of the
organization’s Data Governance/MDM programs. In addition, she was Director of
Product Management for the TriZetto Group, where she helmed a $200 million
expansion and new product and service launch for value-based care analytics.
Rachael earned her Bachelor of Science from Montclair State University and a Master
of Public Administration from New York University. She is a member of PHAM, the
Professional Academy for Healthcare Management.



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