V

Vatica Health

Risk adjustment and quality-of-care solutions

Vice President of Product Management - Risk & Quality AI Solutions

Full-TimeUpdated on 10/17/2026
$200k - $235k/yr+ Discretionary bonus potential
Expert
Bachelor's, Master's, MBA
Remote in USA
Remote
ProductProduct Management

About the job

Requirements
  • At least 10 years of experience in data- or AI-oriented product management, including a track record of building and launching Risk & Quality solutions powered by machine learning or artificial intelligence.
  • Demonstrated success delivering mission-critical, regulated software products at scale, and experience building and leading product teams.
  • Experience operationalizing AI- or data-driven products in production, including evaluation and monitoring frameworks for large language model or natural language processing workflows.
  • Expertise in measurement and evaluation methodologies, including precision and recall, false-positive and false-negative analysis, and continuous performance monitoring.
  • Technical fluency to work closely with Engineering on system architecture, data pipelines, application programming interface design, and integration patterns.
  • Experience working within an AI development lifecycle, from data and model development through evaluation, deployment, monitoring, and iteration.
  • Experience leading or operating in blended offshore/onshore teams, including managing delivery across time zones and distributed collaboration.
  • Experience working in cross-functional product, artificial intelligence, and engineering pods, aligning product, data science, and engineering toward shared outcomes.
  • Working knowledge of Medicare Advantage, hierarchical condition category coding, and Centers for Medicare & Medicaid Services risk adjustment models, including the transition to the v28 model.
  • Communicate product narratives to influence and align stakeholders across product, engineering, clinical, and compliance.
Responsibilities
  • Own the annual roadmap for the Risk & Quality AI Solutions portfolio, aligning it to company priorities and opportunities for new revenue, efficiency, and enhanced client value.
  • Partner with business stakeholders and the machine learning and artificial intelligence team to identify and prioritize high-impact AI-native product bets across the combined Vatica and Cozeva product lines.
  • Design and deliver AI-native solutions using agents, optical character recognition, natural language processing, and large language models to automate clinical and operational workflows while meeting regulated healthcare accuracy standards.
  • Own the AI solution lifecycle end to end, including problem framing, building, evaluation, production monitoring, and retirement, in partnership with Engineering and machine learning/artificial intelligence.
  • Define and scale human-in-the-loop review for chart abstraction, summarization, and coding assistance, balancing automation with clinical and compliance safeguards.
  • Establish evaluation and monitoring frameworks for large-language-model- and natural-language-processing-based workflows, using rigorous measurement methods such as precision/recall and false-positive/negative analysis, with continuous performance monitoring.
  • Define and track key performance indicators for each product and the broader portfolio, tying them to client impact and efficiency gains.
  • Govern AI-related costs and evaluate model and engineering effectiveness to ensure a sustainable, scalable solution suite.
  • Lead responsible-AI policy and practice for the Risk & Quality portfolio, ensuring solutions are transparent, auditable, and compliant with applicable healthcare regulations.
  • Mentor a high-performing product management team, implement objectives and key results, and drive consistent, predictable delivery.
Desired Qualifications
  • Hands-on experience integrating frontier AI models, such as OpenAI GPT or Anthropic Claude, into production products.
  • Experience designing or evaluating large-language-model-powered systems for chart abstraction, summarization, or coding assistance.
  • Familiarity with evaluation tooling such as LangSmith, Ragas, and Phoenix, and with human-in-the-loop review systems.
  • Familiarity with clinical data interoperability standards including FHIR, C-CDA, and HL7, and with health-plan integrations.
  • Understanding of data governance and protected health information security frameworks, including SOC 2, HITRUST, and HIPAA.
  • Background scaling software-as-a-service products for complex workflows across payer and provider ecosystems.
  • An MBA, Master of Public Health, or advanced technical degree is preferred but not required.

About the company

Vatica Health provides risk adjustment and quality-of-care solutions to healthcare providers, health plans, and patients. Its products help clinicians capture accurate health data at the point of care, using proprietary technology that speeds up coding so clinicians can spend more time delivering care. The platform emphasizes compliance to lower audit risk and supports the delivery of Annual Wellness Visits and preventive services. Revenue comes from partnerships with providers and health plans, with growth aided by strategic investment (notably from Great Hill Partners since 2019). The company differentiates itself through a clear focus on compliance and financial performance improvements enabled by its proprietary technology. Its goal is to transform the risk adjustment industry by improving patient outcomes and the financial health of its clients through efficient, compliant clinical encounters.

Company Size

201-500

Company Stage

Early VC

Total Funding

$1.2M

Headquarters

Georgia

Founded

2012

Get referred to Vatica Health

See people who can refer or advise you

Simplify Jobs

Simplify's Take

What believers are saying

  • Blue Shield of California expanded its digital health record using Cozeva on May 15, 2025.
  • The Alliance rolled out Cozeza risk adjustment to TotalCare providers on May 13, 2026.
  • Vatica said on August 25, 2026 the merger caused no disruption to current client engagements.

What critics are saying

  • Tracxn lists 76 active competitors, including Codoxo, Centauri Health Solutions, and Apixio.
  • Keebler raised $16 million in April 2026, funding cheaper AI risk-adjustment rivals.
  • If payers standardize automation, Vatica's services-heavy model gets commoditized and margins collapse.

What makes Vatica Health unique

  • Vatica and Cozeva merged October 31, 2025, joining top KLAS risk and quality platforms.
  • The combined model pairs embedded clinical teams with deeper EMR integrations at point of care.
  • Cozeva won 2026 Best in KLAS for risk adjustment on February 4, 2026.

Help us improve and share your feedback! Did you find this helpful?

Benefits

  • Health Insurance
  • Dental Insurance
  • Vision Insurance
  • Life Insurance
  • Disability Insurance
  • Health Savings Account/Flexible Spending Account
  • Paid Vacation
  • 401(k) Retirement Plan

Growth & Insights and Company News

Headcount

6 month growth

0%

1 year growth

-1%

2 year growth

10%
The Manila Times
Nov 10th, 2025
Vatica Health earns consistent high performer award

Vatica Health earns consistent high performer award. ATLANTA, Nov. 10, 2025 (GLOBE NEWSWIRE) - Vatica Health, the leader in provider-centric risk adjustment and clinical quality solutions, has earned the distinction of being named a 2025 Consistent High Performer from KLAS Research. Consistent High Performers 2025 is a new report from KLAS that identifies companies delivering exceptional client satisfaction and performance over a longer period of time. While the annual Best in KLAS(R) report draws from client data collected over the prior 12-18 months, the new report analyzes performance on a three-year rolling basis. Criteria included how the companies were rated across KLAS' customer experience pillars: culture, loyalty, operations, product, relationship and value. The report also draws from surveys of the consistent high performers who shared nearly identical best practices for maintaining high client customer satisfaction. KLAS issued the new report to help healthcare organizations identify future partners and prompt other HIT vendors to implement these best practices. For three years in a row (December 2021 - December 2024), Vatica has been fully rated and has had an overall performance score of 90+ on a 100-point scale, based on feedback from customers. Vatica is the only company in the risk and quality category recognized as a Consistent High Performer. "We are honored to receive this new recognition from KLAS," said Whitney Chernoff, Vatica's executive vice president of customer success. "This distinction validates the consistent high level of service the Vatica team provides to produce better results for health plans, providers and patients. We're deeply grateful to our clients for their ongoing collaboration and partnership." This recognition reinforces Vatica's commitment to delivering innovative, provider-centric solutions that drive superior clinical and financial performance across the healthcare ecosystem. Details on the KLAS Consistent High Performers 2025 report can be found here. About Vatica Health Founded in 2011, Vatica Health is the #1 ranked risk adjustment and quality of care solution for health plans and health systems. By pairing expert clinical teams with cutting-edge technology at the point of care, Vatica increases patient engagement and wellness, improves coding accuracy and completeness, identifies and closes gaps in care and enhances communication and collaboration between providers and health plans. The company's unique solution helps providers, health plans and patients achieve better outcomes, together. Vatica Health is trusted by many of the leading health plans and thousands of providers nationwide. More information can be found here. KLAS has been providing accurate, honest and impartial insights for the healthcare IT (HIT) industry since 1996. The KLAS mission is to improve the world's healthcare by amplifying the voice of providers and payers. The scope of KLAS research is constantly expanding to best fit market needs as technology becomes increasingly sophisticated. KLAS finds the hard-to-get HIT data by building strong relationships with payers and providers in the industry. Follow KLAS on LinkedIn. Learn more at klasresearch.com.

GlobeNewswire
Nov 3rd, 2025
Vatica Health merges with Cozeva

Vatica Health has merged with Cozeva, combining Vatica's top-rated risk adjustment platform with Cozeva's leading quality platform to enhance value-based care enablement. This merger aims to improve patient and financial outcomes by offering integrated solutions for risk adjustment, quality, data analytics, and clinical services. The combined entity will support providers and payers in optimizing care and performance in the healthcare ecosystem.

Business Wire
Feb 7th, 2024
Vatica Health Earns Second Consecutive Best In Klas Award

ATLANTA--(BUSINESS WIRE)--Vatica Health, the leader in provider-centric risk adjustment and clinical quality solutions, is pleased to announce that it has earned the 2024 Best in KLAS distinction in the Risk Adjustment Software and Professional Services category. This is the second year in a row Vatica has received this honor. KLAS’ analysis of the risk adjustment competitive landscape included numerous vendors and in-depth interviews with dozens of payers and providers. Customers rate each solution across six customer experience categories—culture, loyalty, operations, product, relationship and value—providing an overall assessment of customer satisfaction. Based on extensive client feedback, Vatica received an overall score of 93.6 (on a 100-point scale), the highest in the risk adjustment category. This reflects Vatica’s intense commitment to client success, innovation and delivering tangible results that significantly exceed customer expectations

Business Wire
Feb 7th, 2024
Vatica Health Earns Second Consecutive Best in KLAS Award

Vatica Health earns second consecutive Best in KLAS award.

The Bakersfield Californian
Feb 8th, 2023
Vatica Health Wins Best in KLAS Award for Risk Adjustment | News | bakersfield.com

Vatica Health, the leader in provider-centric risk adjustment and clinical quality solutions, has been awarded the 2023 Best in KLAS distinction in the Risk Adjustment Software and Professional Services category.