Vatica Health Logo

Vatica Health

Risk Solution Director

Posted 16 Days Ago
Be an Early Applicant
Remote
Hiring Remotely in United States
150K-175K Annually
Senior level
Remote
Hiring Remotely in United States
150K-175K Annually
Senior level
Owns the Risk Adjustment domain across the solution portfolio, including roadmap strategy, solution standards, portfolio gap analysis, pilots, market intelligence, regulatory monitoring, value narratives, and cross-segment consistency. The director influences Product, Technology, Sales, Customer Success, and Services while driving measurable product-market fit, commercial outcomes, and domain integrity.
The summary above was generated by AI

The Risk Solutions Director is the company’s authoritative expert on clinical or program domains and is accountable for how that domain performs across the entire solution portfolio. This role focuses on the domain of Risk Adjustment across all lines of business.

 The Risk Solution Director operates as a deep specialist across all segments and lines of business. This is not an SME support or technical advisory role. The Risk Solutions Director owns outcomes: domain-level product-market fit, the strength of the value narrative, and the clinical or programmatic integrity of what the company sells and delivers. It requires equal parts domain command, commercial orientation, and cross-functional influence.

Domain Strategy & Portfolio Authority

  • Drive the domain roadmap. Maintain a current, prioritized view of where the domain needs to go - capabilities, depth, competitive differentiation - and translate that into actionable product input.  
  • Define what “good” looks like. Establish outcome standards, solution design principles, and minimum viable configurations for the domain  
  • Identify and close portfolio gaps. Quantify capability shortfalls that limit commercial performance, build the investment case with ROI rationale, and drive prioritization decisions with leadership.
  • Own discovery, prioritization and scoping on customer feedback and requests provided via intake process, identifying thematic improvements and actioning on key requests within the domain – both customer-specific and global.

 Cross-Segment Solution Design

  • Run domain-level pilots and validation. Lead incubation of new domain capabilities or modules, including design of the test, success criteria, and decision framework for productization.
  • Maintain cross-segment consistency. Ensure that domain solutions deployed across segments do not fragment into one-offs. Standardization of the domain layer is your accountability.

 Market & Competitive Intelligence

  • Own the domain value narrative. Develop and maintain the authoritative story for the domain: buyer-ready proof points and competitive differentiation.
  • Own domain-level market intelligence. Track regulatory developments (e.g., ONC/CMS rule changes, CMMI program evolution), competitive moves, and buyer expectation shifts within your domain. Synthesize signal from noise and surface forward-looking implications, not just observations.

 Cross-Functional Leadership

  • Influence without authority. Drive alignment across Product & Technology, Sales, Customer Success, and Services on domain-related decisions. Earn trust through clarity and credibility.
  • Support growth objectives as needed as a subject matter expert with domain knowledge.

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: has operated in or closely adjacent to revenue-generating functions. Understands how the domain translates to buyer ROI and can build a value narratives independently

Preferred Skills & Experience:

  • Regulatory depth: has tracked and responded to CMS rulemaking or CMMI program evolution in real time.
  • Experience building or evaluating domain-specific content assets, workflows, or analytics that are embedded in customer operations at scale.
  • Familiarity with both sides of the payer–provider relationship in the context of the target domain - understands how incentives and accountability are distributed across the ecosystem.
  • Cross-functional influence: can name the mechanisms used to drive alignment across Product, Sales, and CS without direct authority
  • Analytical discipline: defines the right domain-level metrics, tracks them, and uses data to drive investment and prioritization decisions
  • Executive communication: precise and credible with VP and C-suite audiences, both internal and customer-facing.  
Competencies:   

Business Insight & Organizational Savvy

  • Aligns tasks and initiatives with company priorities, translating goals into actionable plans with clear milestones.
  •  Navigates organizational dynamics effectively, engaging key stakeholders and leveraging resources to develop strategic solutions.
  • Regularly evaluates and adjusts priorities to ensure meaningful impact and results.

Manages Ambiguity & Complexity

  • Navigates uncertainty and change with flexibility, making decisions despite incomplete information.
  • Collaborates to find solutions, manages risk, and remains productive in ambiguous situations, viewing complexity as an opportunity

 Plans and Aligns, Resourcefulness

  • Plans and prioritizes work to meet business goals, breaking objectives into actionable steps.
  • Anticipates challenges, adjusts plans, and organizes resources for efficiency.
  • Continuously adapts priorities and maintains focus on key milestones.

 Situational Adaptability & Flexibility

  • Quickly adjusts approach to meet changing situations, demonstrating high versatility and adaptability.
  • Focuses on making a positive impact in every interaction and remains positive when quick pivots are needed, seamlessly fitting into any environment.

 Strategic Mindset

  • Anticipates future trends and potential roadblocks, creating strategies to drive results.
  • Thinks ahead, connects vision to action, and evaluates risks and rewards from all perspectives to make informed decisions.

Critical Thinking

  • Proactively seeks innovative solutions and analyzes information to make informed, well-balanced decisions.
  • Evaluates both positive and negative aspects of a situation, considering all factors before acting.
  • Demonstrates decisiveness while clearly communicating the rationale behind decisions.

Benefits

WORKING AT VATICA HEALTH ADVANTAGES

Prosperity

  • Competitive salary based on your experience and skills – we believe the top talent deserves the top dollar
  • Bonus Potential (based on role and is discretionary) – if you go above and beyond, you should be rewarded
  • 401k plans– we want to empower you to prepare for your future
  • Room for growth and advancement- we love our employees and want to develop within

Good Health

  • Comprehensive Medical, Dental, and Vision insurance plans
  • Tax-free Dependent Care Account
  • Life insurance, short-term, and long-term disability

Happiness

  • Excellent PTO policy (everyone deserves a vacation now and then)
  • Great work-life balance environment- We believe family comes first!
  • Strong supportive teams- There is always a helping hand when you need it

The salary for a position is typically determined by multiple factors such as the individual's qualifications, experience, skills, and location. The projected compensation range for the position may vary based on these factors and could range from $150,000 to $175,000 (annualized USD). However, this estimate represents just one aspect of our total compensation package offered.

Similar Jobs

2 Minutes Ago
In-Office or Remote
74K-129K Annually
Senior level
74K-129K Annually
Senior level
Artificial Intelligence • Cloud • Fintech • Information Technology • Insurance • Financial Services • Big Data Analytics
Leads a team of Absence Claim Managers responsible for short-term disability, statutory leave, and paid family medical leave processes. Oversees quality, compliance, performance, coaching, escalations, client service, metrics, and continuous improvement. Partners with Account Management, Sales, and internal stakeholders to resolve complex cases, maintain service levels, and improve operational effectiveness across absence and disability claims.
2 Minutes Ago
In-Office or Remote
125K-150K Annually
Expert/Leader
125K-150K Annually
Expert/Leader
Artificial Intelligence • Cloud • Fintech • Information Technology • Insurance • Financial Services • Big Data Analytics
Direct sales of New York Life Stable Value Investment Only products across the Western U.S. Develop territory growth plans, build relationships with plan advisors, consultants, intermediaries, and fiduciaries, manage prospecting and sales pipelines, deliver investment presentations, meet sales metrics, and provide market and competitor feedback. The role targets up to $500 million in annual asset sales and requires strong defined contribution industry expertise and financial services relationships.
Top Skills: Finra Series 6Salesforce
2 Minutes Ago
In-Office or Remote
52K-74K Annually
Entry level
52K-74K Annually
Entry level
Artificial Intelligence • Cloud • Fintech • Information Technology • Insurance • Financial Services • Big Data Analytics
Supports New York Life agents through administrative, operational, new-business, marketing, and compliance workflows. Tracks insurance cases from submission through placement, maintains client records, coordinates appointments and service requests, supports marketing calendars and events, prepares reports, and collaborates with underwriting, licensing, compliance, and field operations teams to resolve issues and improve service delivery.
Top Skills: App CentralCase Management SystemsCrm PlatformsMarketing CentralExcelMS OfficeMicrosoft OutlookRevverSales Central

What you need to know about the Chicago Tech Scene

With vibrant neighborhoods, great food and more affordable housing than either coast, Chicago might be the most liveable major tech hub. It is the birthplace of modern commodities and futures trading, a national hub for logistics and commerce, and home to the American Medical Association and the American Bar Association. This diverse blend of industry influences has helped Chicago emerge as a major player in verticals like fintech, biotechnology, legal tech, e-commerce and logistics technology. It’s also a major hiring center for tech companies on both coasts.

Key Facts About Chicago Tech

  • Number of Tech Workers: 245,800; 5.2% of overall workforce (2024 CompTIA survey)
  • Major Tech Employers: McDonald’s, John Deere, Boeing, Morningstar
  • Key Industries: Artificial intelligence, biotechnology, fintech, software, logistics technology
  • Funding Landscape: $2.5 billion in venture capital funding in 2024 (Pitchbook)
  • Notable Investors: Pritzker Group Venture Capital, Arch Venture Partners, MATH Venture Partners, Jump Capital, Hyde Park Venture Partners
  • Research Centers and Universities: Northwestern University, University of Chicago, University of Illinois Urbana-Champaign, Illinois Institute of Technology, Argonne National Laboratory, Fermi National Accelerator Laboratory

Sign up now Access later

Create Free Account

Please log in or sign up to report this job.

Create Free Account