Senior Solutions Consultant - Retrospective Risk Adjustment

Cotiviti

1d • $140,000 - $175,000 • Remote

About The Position

The Solution Consultant for Retrospective Risk Adjustment serves as Cotiviti's subject matter expert and "voice of product" in the field for our retrospective risk adjustment solutions. This role partners directly with Sales teams to drive complex deal pursuits, deliver product demonstrations, support RFP responses, and provide deep technical expertise during customer engagements. The Solution Consultant also serves as a critical feedback channel, bringing market intelligence and customer insights back to Product Management to inform roadmap decisions.

Requirements

• Bachelor's degree in Healthcare Administration, Business, or related field
• 10+ years of experience in healthcare technology, risk adjustment operations, or health plan consulting
• Deep knowledge of Medicare Advantage retrospective risk adjustment programs and operations
• Experience in pre-sales, solution consulting, or customer-facing product roles
• Strong presentation and demonstration skills with executive audiences
• Ability to translate complex technical capabilities into business value propositions
• Excellent written communication skills for RFP responses and technical documentation
• Willingness to travel up to 25% for customer meetings and industry events
• Ability to analyze complex information and communicate it clearly to diverse audiences.
• Strong critical thinking, problem solving, and decision-making skills.
• Capacity to manage multiple proprieties and maintain attention to detail.
• Effective memory and recall to stay current on solution knowledge and industry practices.
• Mental flexibility to adapt communication style and approach to different situations.
• Ability to remain composed and think quickly under pressure.
• Strong organizational and planning skills to support client engagements and sales activities.
• Remaining in a stationary position, often standing or sitting for prolonged periods.
• Repeating motions that may include the wrists, hands, and/or fingers.
• Must be able to provide high-speed internet access / connectivity and office setup and maintenance.
• Must be able to provide a dedicated, secure work area.

Nice To Haves

• Prior role in health plan risk adjustment or revenue optimization operations
• Familiarity with medical record retrieval, HCC coding, and encounter data submission
• Understanding of Commercial and Medicaid risk adjustment models
• Experience with healthcare analytics platforms and data visualization to

Responsibilities

• Partner with Sales on strategic opportunities involving retrospective risk adjustment solutions.
• Lead product demonstrations and technical deep-dives for prospective and existing customers.
• Present Cotiviti's retrospective risk adjustment capabilities to health plan executives and operational leaders.
• Support discovery sessions to understand customer challenges, workflows, and requirements.
• Participate in customer site visits and executive presentations for strategic accounts.
• Develop and maintain technical content for retrospective risk adjustment RFP responses.
• Collaborate with Sales, Product, and Legal to craft compelling and accurate proposal responses.
• Present solutions during finalist presentations and orals.
• Support pricing discussions with technical validation of scope and delivery approach.
• Capture and synthesize customer feedback, competitive intelligence, and market trends.
• Communicate product gaps, enhancement requests, and market needs to Product Management.
• Participate in product roadmap discussions to ensure alignment with market demands.
• Contribute to competitive battlecards and sales enablement materials.
• Maintain deep expertise in Medicare Advantage retrospective risk adjustment operations
• Stay current on CMS-HCC model changes, RADV audit requirements, and industry best practices
• Understand the end-to-end retrospective risk adjustment workflow: chart retrieval, coding, analytics, and submission
• Develop training materials and conduct internal enablement sessions for Sales teams

Benefits

• Cotiviti offers team members a competitive benefits package to address a wide range of personal and family needs, including medical, dental, vision, disability, and life insurance coverage, 401(k) savings plans, paid family leave, 9 paid holidays per year, and 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti.
• This role is eligible for discretionary bonus consideration.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior