Risk Solution Director

🔥 13 hours ago

🇺🇸 United States – Remote

💵 $150k - $175k / year

⏰ Full Time

🔴 Lead

🎲 Risk

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Vatica Health

WebsiteLinkedInAll Job Openings

201 - 500 employees

🏥 Healthcare

⚕️ Healthcare Insurance

☁️ SaaS

💰 $1.2M Venture Round on 2013-11

Healthcare • Healthcare Insurance • SaaS

Vatica Health is a healthcare company that offers advanced solutions for risk adjustment and quality of care. By combining expert clinical teams with cutting-edge technology, Vatica Health improves financial performance for health plans and providers by capturing accurate diagnosis codes and reducing audit risks. The company's model enhances provider utilization of preventive services and patient engagement, while also supporting quality programs at the time of patient visits. With seamless integration into provider workflows, Vatica Health focuses on increasing coding accuracy, compliance, and efficiency, ultimately benefiting health plans, providers, and patients. Their EMR-agnostic technology and on-site clinical consultants ensure improved care delivery and wellness outcomes, particularly through services like Annual Wellness Visits.

📋 Description

• Drive the Risk Adjustment domain roadmap across all lines of business. • Establish outcome standards, solution design principles, and minimum viable domain configurations. • Identify and close portfolio gaps, quantify capability shortfalls, build ROI-based investment cases, and drive prioritization with leadership. • Own discovery, prioritization, and scoping of customer feedback and requests through the intake process. • Lead domain-level pilots and validation, including test design, success criteria, and productization decision frameworks. • Ensure cross-segment consistency and prevent domain solutions from fragmenting into one-off implementations. • Develop and maintain the authoritative domain value narrative, buyer-ready proof points, and competitive differentiation. • Track regulatory developments, competitive moves, and buyer expectation shifts; synthesize implications. • Drive alignment across Product & Technology, Sales, Customer Success, and Services without direct authority. • Support growth objectives as a subject matter expert in Risk Adjustment.

🎯 Requirements

• 5+ years in healthcare SaaS, clinical services, or health plan operations, with deep expertise in Risk Adjustment. • Direct experience at a healthcare SaaS company in a product, solutions, or strategy role with domain accountability. • Demonstrated ownership of a domain-level strategy or product area with measurable outcomes • Commercial orientation and experience with revenue-generating functions; understands buyer ROI and can build value narratives independently • Regulatory depth tracking and responding to CMS rulemaking or CMMI program evolution in real time • Experience building or evaluating domain-specific content assets, workflows, or analytics embedded in customer operations at scale • Familiarity with both sides of the payer–provider relationship in the target domain • Ability to drive cross-functional alignment across Product, Sales, and Customer Success without direct authority • Analytical discipline defining domain-level metrics and using data for investment and prioritization decisions • Precise and credible executive communication with VP and C-suite audiences, internally and customer-facing • Ability to align initiatives with company priorities and translate goals into actionable plans • Ability to navigate organizational dynamics, uncertainty, change, ambiguity, and complexity • Ability to plan, prioritize, anticipate challenges, and organize resources • Situational adaptability and flexibility • Strategic mindset • Critical thinking and decisive, well-balanced decision-making

🏖️ Benefits

• Competitive salary based on your experience and skills • Bonus Potential (based on role and is discretionary) • 401k plans • Room for growth and advancement • Comprehensive Medical, Dental, and Vision insurance plans • Tax-free Dependent Care Account • Life insurance, short-term, and long-term disability • Excellent PTO policy • Great work-life balance environment • Strong supportive teams