Risk Solution Director

This is a fully remote position, open to applicants in United States.

📋 Description

• Oversee the Risk Adjustment domain roadmap for all business lines.

• Set outcome standards, solution design guidelines, and essential domain configurations.

• Identify and address portfolio gaps, assess capability shortfalls, create ROI-driven investment cases, and facilitate prioritization with leadership.

• Manage the discovery, prioritization, and scoping of customer feedback and requests through the intake process.

• Lead pilots and validation at the domain level, including test design, success criteria, and frameworks for productization decisions.

• Ensure consistency across segments and avoid fragmentation of domain solutions into isolated implementations.

• Create and maintain the authoritative domain value narrative, proof points ready for buyers, and competitive differentiation.

• Monitor regulatory changes, competitive actions, and shifts in buyer expectations; synthesize their implications.

• Foster alignment among Product & Technology, Sales, Customer Success, and Services without direct authority.

• Contribute as a subject matter expert in Risk Adjustment to support growth objectives.

⛳️ Requirements

• Over 5 years of experience in healthcare SaaS, clinical services, or health plan operations, with extensive knowledge in Risk Adjustment.

• Direct experience in a healthcare SaaS company within a product, solutions, or strategy role that holds domain accountability.

• Proven track record of ownership in a domain-level strategy or product area with quantifiable outcomes.

• Commercially oriented with experience in revenue-generating functions; understands buyer ROI and can independently construct value narratives.

• In-depth regulatory knowledge, tracking and responding to CMS rulemaking or CMMI program changes in real time.

• Experience in creating or assessing domain-specific content assets, workflows, or analytics integrated into customer operations at scale.

• Understanding of both aspects of the payer-provider relationship within the target domain.

• Capability to drive cross-functional alignment among Product, Sales, and Customer Success without direct authority.

• Strong analytical skills to define domain-level metrics and leverage data for investment and prioritization decisions.

• Ability to communicate precisely and credibly with VP and C-suite audiences, both internally and externally.

• Skill in aligning initiatives with company goals and translating objectives into actionable plans.

• Proficiency in navigating organizational dynamics, uncertainty, change, ambiguity, and complexity.

• Strong planning, prioritization, and resource organization skills.

• Adaptability and flexibility in various situations.

• Strategic thinking capabilities.

• Strong critical thinking and balanced decision-making skills.

🏝️ Benefits

• Competitive salary based on your experience and skills.

• Bonus potential (contingent on role and at the company's discretion).

• 401k plans available.

• Opportunities for growth and advancement.

• Comprehensive Medical, Dental, and Vision insurance plans.

• Tax-free Dependent Care Account.

• Life insurance, short-term, and long-term disability coverage.

• Excellent PTO policy.

• Positive work-life balance environment.

• Strong and supportive teams.