V

Vatica Health

Risk adjustment and quality-of-care solutions

Risk Solution Director

Full-TimeUpdated on 10/23/2026
$150k - $175k/yr+ Discretionary bonus potential
Senior, Expert
Remote in USA
Remote
ProductProduct Management

About the job

Requirements
  • Have at least 5 years of experience in healthcare software as a service, clinical services, or health plan operations, with deep expertise in Risk Adjustment.
  • Have direct experience at a healthcare software as a service company in a product, solutions, or strategy role with domain accountability.
  • Have demonstrated ownership of a domain-level strategy or product area with measurable outcomes.
  • Have a commercial orientation and experience operating in or closely adjacent to revenue-generating functions; understand how the domain translates to buyer return on investment and independently build value narratives.
  • Align tasks and initiatives with company priorities, translating goals into actionable plans with clear milestones.
  • Navigate organizational dynamics effectively, engage key stakeholders, and leverage resources to develop strategic solutions.
  • Regularly evaluate and adjust priorities to ensure meaningful impact and results.
  • Navigate uncertainty and change with flexibility, make decisions despite incomplete information, collaborate to find solutions, manage risk, and remain productive in ambiguous situations.
  • Plan and prioritize work to meet business goals, break objectives into actionable steps, anticipate challenges, adjust plans, and organize resources efficiently.
  • Adapt approaches to changing situations and maintain effectiveness when quick pivots are needed.
  • Anticipate future trends and potential roadblocks, create strategies to drive results, connect vision to action, and evaluate risks and rewards.
  • Seek innovative solutions, analyze information, evaluate relevant considerations, make informed decisions, and communicate the rationale.
Responsibilities
  • Drive the domain roadmap by maintaining a current, prioritized view of needed capabilities, depth, and competitive differentiation, and translate it into actionable product input.
  • Establish outcome standards, solution design principles, and minimum viable configurations for the domain.
  • Identify and quantify portfolio capability gaps that limit commercial performance, build investment cases with return-on-investment rationale, and drive prioritization decisions with leadership.
  • Own discovery, prioritization, and scoping of customer feedback and requests through the intake process; identify thematic improvements and action key requests within the domain, both customer-specific and global.
  • Lead domain-level pilots and validation, including designing tests, success criteria, and decision frameworks for productization of new capabilities or modules.
  • Maintain consistency of domain solutions across segments and prevent fragmentation into one-off solutions; own standardization of the domain layer.
  • Develop and maintain the authoritative domain value narrative, including buyer-ready proof points and competitive differentiation.
  • Track regulatory developments, including ONC and CMS rule changes and CMMI program evolution, competitive moves, and buyer expectation shifts; synthesize implications and surface forward-looking insights.
  • Drive alignment across Product and Technology, Sales, Customer Success, and Services on domain-related decisions through influence and credibility.
  • Support growth objectives as needed as a subject matter expert with domain knowledge.
Desired Qualifications
  • Have experience tracking and responding to CMS rulemaking or CMMI program evolution in real time.
  • Have experience building or evaluating domain-specific content assets, workflows, or analytics embedded in customer operations at scale.
  • Be familiar with both sides of the payer–provider relationship in the target domain and understand how incentives and accountability are distributed across the ecosystem.
  • Be able to identify mechanisms for driving alignment across Product, Sales, and Customer Success without direct authority.
  • Define appropriate domain-level metrics, track them, and use data to drive investment and prioritization decisions.
  • Communicate precisely and credibly with VP and C-suite audiences, both internally and in customer-facing settings.

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

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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.

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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

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.