Senior Solutions Consultant - Risk Adjustment
Remote · USFull-timeSeen 2w agoSeen in employer's feed 5 days ago
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Job overview
The Senior Solutions Consultant for Risk Adjustment serves as a subject matter expert and trusted advisor on payer and provider risk adjustment, focusing on prospective and concurrent strategies. The role partners with Sales and cross-functional teams to understand client needs, assess solution fit, demonstrate capabilities, support proposals, and shape recommendations. It also brings customer and market insights to Product teams and supports compliant risk identification, documentation, provider workflows, and financial performance.
Skills & qualifications
Skills
Full job description
Senior Solutions Consultant - Risk Adjustment Job Locations US-Remote ID 2026-20542 Category Product Management Position Type Full-Time Overview The Senior Solutions Consultant for Risk Adjustment serves as Cotiviti's subject matter expert and trusted advisor for payer and provider risk adjustment, with a primary focus on prospective and concurrent strategies. This role partners with Sales and cross-functional teams to understand client needs, assess solution fit, deliver compelling demonstrations and presentations, support RFP responses, and shape solutions that improve compliant risk identification, documentation, provider workflows, and financial performance. The Senior Solutions Consultant translates client and market needs into solution recommendations and brings field insights back to Product teams. Responsibilities Pre-Sales Support and Customer Engagement: Partner with Sales on opportunities involving risk adjustment analytics, prospective and concurrent workflows, and provider engagement. * Demonstrate Cotiviti's risk adjustment analytics, workflow, and decision-support capabilities. * Present to health plan risk adjustment, coding, clinical, provider engagement, technology, and executive teams. * Conduct discovery sessions to understand customer risk adjustment strategies, current workflows, data and integration requirements, operational challenges, and success measures. * Support pilot and proof-of-concept initiatives that demonstrate solution value, operational fit, and measurable outcomes. Solution Design and RFP Support: * Develop technical content for risk adjustment RFP and proposal responses. * Design solution recommendations that address customer-specific prospective and concurrent risk adjustment needs, provider workflows, and operational challenges. * Articulate ROI and business value tied to compliant risk identification, documentation accuracy, provider workflow efficiency, and timely intervention. * Present during finalist presentations with a clear focus on client outcomes, workflow fit, and measurable value. Market Intelligence and Product Feedback: * Monitor regulatory, market, and operational trends affecting Medicare Advantage risk adjustment, prospective and concurrent strategies, and provider workflows. * Capture competitive intelligence on risk adjustment analytics, workflow solutions, and related market offerings. * Communicate customer needs, solution gaps, and enhancement priorities to Product Management. * Contribute to risk adjustment case studies, sales enablement materials, commercialization content, and thought leadership. Subject Matter Expertise: * Maintain deep expertise in health plan risk adjustment strategies and operations, with emphasis on prospective and concurrent approaches. * Maintain expertise in CMS-HCC models, compliant documentation and coding, provider engagement, and risk adjustment program operations. * Understand end-to-end risk adjustment workflows, including risk identification and prioritization, provider engagement, point-of-care review, post-encounter validation, concurrent review, coding, and encounter submission. * Stay current on risk adjustment model changes, documentation and coding guidance, regulatory requirements, and industry best practices. * Develop training materials and deliver internal enablement on risk adjustment concepts, client needs, and solution positioning. This job description is intended to describe the general nature and level of work being performed and is not to be construed as an exhau stive list of responsibilities, duties, and skills required. This job description does not constitute an employment agreement and is subject to change as the needs of Cotiviti and the... For full info follow application link. Equal Opportunity Employer/Protected Veterans/In ividuals with Disabilities
How this job compares
Set against the 395 open Solutions Consultant jobs on Olive Jobs, counted November 11, 2026.
- Pay
- This postingNot listed
- US median$126–180K/yr325 salary ranges
- Openings
- Olive Jobs lists 395 open Solutions Consultant jobs across the US. 29% of them nationwide are listed as remote or flexible.
- Hiring the most across the US
- Palo Alto Networks77 open
- CBRE53 open
- Braze17 open
- Experience
- Solutions Consultant postings that state a minimum ask for 5 years of experience at the median; the middle half ask for 4 to 6 years (263 postings).
- Education
- 51 of the 395 open Solutions Consultant jobs (13%) ask for a bachelor's degree or higher.
Counted across the open, public US postings on Olive Jobs on November 11, 2026. Pay medians are the middle values of the low ends and of the high ends of postings that list both ends of a range in the same cadence (a yearly salary or an hourly rate); a range's midpoint is halfway between its ends. Pay and experience figures resting on fewer than 20 postings are left out.
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