Cotiviti has named Erin Schmuker (pictured) as chief operating officer, bringing more than two decades of payment integrity experience to a company whose claims accuracy tools already run inside self-funded employer plans that a growing share of the US workforce depends on.
Schmuker joins from Optum, where she most recently served as president of pharmacy care services beginning in November 2025. Her Optum tenure, which spanned nearly 17 years, included roles as chief executive officer of Optum Ireland and Optum UK from October 2023 to December 2025, and chief integration officer during a roughly $16 billion asset integration in 2022 and 2023.
Earlier in her career, she spent eight years at AIM Healthcare working directly in overpayment recovery and provider revenue cycle consulting, work that sits close to the claims accuracy function she will now oversee at Cotiviti. She will report to president and chief executive officer Ric Sinclair.
Cotiviti works with more than 200 healthcare organizations, including all 25 of the largest US health plans, and its clients collectively provide coverage for more than 300 million members and patients. Much of that reach runs through payment integrity tools that catch billing errors before or after claims are paid, a function health plans and third-party administrators increasingly extend to the self-funded employer groups they serve.
Self-funding has become the default for a large share of the US workforce, shifting the stakes of that extension onto the employer directly. The Kaiser Family Foundation's 2025 Employer Health Benefits Survey found that 80 percent of covered workers at large companies are enrolled in self-funded health plans, a structure that shifts claims risk, and the cost of claims errors, directly onto the employer rather than a carrier.
The healthcare payment integrity market itself was valued at $17.06 billion in 2026 and is projected to grow at a 12.86 percent compound annual rate to $31.25 billion by 2031, according to Mordor Intelligence, with Cotiviti named among the sector's major players alongside Optum, Conduent, and Zelis.
Sinclair framed the hire around execution rather than strategy. "Healthcare doesn't have a data problem. It has a coordination problem," he said, adding that Schmuker's operating background positions her to "help us move faster, operate better and scale Cotiviti for what healthcare needs next."
As chief operating officer, Schmuker will lead enterprise operations and work to translate Cotiviti's investments in AI and automation into measurable client outcomes, according to the company's announcement.
The timing lines up with a broader shift already underway in payment integrity, where a persistent industry-wide claims-error rate near 6 percent has pushed health plans and their self-funded clients to move error detection earlier, before a claim is paid, rather than recovering losses after the fact. Cotiviti's self-funded clients work through TPA and health plan relationships that brokers also touch, and the hire lands as catastrophic claims drive up stop-loss costs that self-funded plan sponsors are already absorbing.
