Vice President Risk Adjustment & Quality

Overview

This is a hunter role in the healthcare payer space. Extensive experience calling on and selling to Health Plan “C” level executives, SVP Business Owners, procurement, VPs and directors is essential. Experience working in a leading Health Plan software and service vendor in the Risk Adjustment and Quality space is required with specific experience selling Coordination of Benefits and/or Data Mining solutions being highly desired. We are looking for candidates across the US.

Responsibilities

• Develop immediate and practical experience in securing new sales and vetting new approaches in a growing but developed market.
• Manage a sales territory and corresponding quota.
• Drive the implementation of effective Sales strategies and policies.
• Implement strategic sales activities. Provide regular updates to Chief Growth Officer and sales management.
• Research and analyze environmental and competitive conditions, customer needs, and market trends. Recommend strategies to capitalize on market opportunities and ensure strategic sales plans complement marketplace needs.
• Ensure sales activities are cost effective, efficient, and are performed within established budget constraints.
• Monitor competitor’s prices, market price sensitivity, and create effective pricing strategies.
• Provide recommendations for improvements in sales and service delivery, programs, and procedures.
• Ensure existing customers are serviced in accordance with Company standards and policies.
• Develop strong relationships with all customers, trade professionals, and external contacts.
• Establish and maintain effective communication and coordination with Company’s internal departments and teams.
• Attend industry trade shows, professional meetings, and seminars.
• Keep up to date on industry, market, product, and technology trends.
• Complete all responsibilities as outlined on annual Performance Plan.
• Complete all special projects and other duties as assigned.
• Must be able to perform duties with or without reasonable accommodation.

This job description is intended to describe the general nature and level of work being performed and is not to be construed as an exhaustive 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 requirements of the job change.

Qualifications

• Bachelor’s Degree or the equivalent work experience in Healthcare, Marketing, Business or related field required.
• 12-15 years’ experience prospecting new business accounts and selling software products in a hunter sales role.
• Minimum 5+ years’ experience selling into Health Plans. 7+ years’ experience preferred.
• Extensive experience calling on and selling to Health Plan “C” level executives, SVP Business Owners, procurement, VPs and directors.
• Proven track record closing Health Plan software system and service sales with contract values ranging from hundreds of thousands to tens of millions.
• Experience working in a leading Health Plan software and service vendor in the Risk Adjustment and Quality space is required with specific experience selling Risk Adjustment retrieval, coding services, retrospective risk platforms, prospective risk platforms and Quality HEDIS and Stars.
• Must have a network of Heath Plan account contacts at the Executive level.
• Excellent understanding of market penetration strategies, market development techniques, and market segmentation strategies.
• Able to work in a fast-paced, high growth environment and perform multiple roles and functions.
• Demonstrated experience managing sales process, pursuit teams and closing process.
• Possesses strong leadership skills and can educate and create a high-performance sales team.
• Strong organizational and quality management skills with ability to handle multiple, competing tasks and priorities.
• Strong interpersonal skills with ability to effectively communicate with a diverse group of stakeholders (prospects, clients, hospital executives, nurses, implementation staff, etc.).
• Outstanding verbal, written and presentation skills.
• Experience with sales CRMs (e.g. Salesforce, MS Dynamics, etc.).
• Adoption of AI tools (i.e., Co-Pilot) to improve sales and productivity throughout.
• Excellent command of selling process and discipline to following sequence of events to close business.
• Ability to travel 20 to 40% of the time.
• Must have a network of Heath Plan account contacts at the Executive level.

MENTAL REQUIREMENTS

• Assessing the accuracy, neatness and thoroughness of the work assigned.
• Demonstrated ability to balance activities across multiple internal customers, campaigns, tasks, and performance pressures.
• Strong analytical skills with the demonstrated ability to research prospective customers and plan sales prospecting activities accordingly.
• Excellent oral and written skills.
• Strong interpersonal skills required. Understands that internal customers’ interests are best served through continuous prospecting and intelligence gathering activities and proactive communication with sales partners.
• Must be able to perform daily functions with little or no direct supervision.

PHYSICAL REQUIREMENTS AND WORKING CONDITIONS

• 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 a dedicated, secure work area.
• Must be able to provide high-speed internet access/connectivity and office setup and maintenance.
• No adverse environmental conditions are expected.

Base compensation ranges from $147,000 to $192,000 per year. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs.

This role is eligible for commission.

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. For information about our benefits package, please refer to our Careers page.

Since this job will be based remotely, all interviews will be conducted virtually.

Date of posting: 8/25/2026

Applications are assessed on a rolling basis. We anticipate that the application window will close on 10/25/2026, but the application window may change depending on the volume of applications received or close immediately if a qualified candidate is selected.

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