AVP Electronic Risk Adjustment SME
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Posted 6 days ago
Job Description

The AVP, Business Consulting will partner with the Risk Adjustment Sales Executives to support the development of sales opportunities for Risk Adjustment and Quality across the payer market. As such, this role is primarily responsible for driving the solution design for customers and prospects evaluating Risk and Quality solutions. The AVP, Business Consulting will do this by engaging in consultative discussions with clients and prospects to align Risk and Quality capabilities with their business and technical needs. This resource will need to have a detailed understanding of Risk Adjustment and Quality and be able to discuss all aspects of the solution with our customers and prospects. Part of the two-way communications with clients and prospects includes bringing feedback to the Decision Analytics and Chart Retrieval/Coding product teams for refinement of the strategy and development of new capabilities. Additionally, the AVP, Business Consulting will serve as a subject matter expert in support of Risk Adjustment Requests for Information, Requests for Proposals, and Development of Risk and Quality Marketing and Sales tools. This resource will also work with Change Healthcare Sales Executives, Account Managers, and Product Managers.

What will be my duties and responsibilities in this job?

Client Engagement/Sales Support. Partner with Sales and Account Management to develop relationships that span a wide variety of areas within a health plan to discover and develop sales opportunities for clients and prospects to leverage CHC's suite of Risk and Quality solutions. Activities should leverage the Solution Design Sales Toolkit and include facilitation of discovery conversations, tailoring solution presentations, and providing solution demonstrations. Additionally, partner with Solution Design Technical Consultant to provide technical overviews and facilitate discussions with customers/prospects IT teams.

Solution Design. Partner with CHC Analytics to gather and run data in order to complete opportunity value Analysis. Review the SOA results with the customers/prospects and facilitate a detailed vetting process to define the scope of the solution and implementation roadmap and assist customers/prospects with a business case for the solution.

Subject Matter Expertise. Provide industry and solution expertise in support of Risk and Quality Requests for Information, Requests for Proposal, and Development of sales and marketing tools. Additionally, the AVP, Business Consulting will represent Change Healthcare through participation in conferences and events.

Solution Development and Enhancement. Bring market knowledge and feedback gathered through sales and consulting activities back to Risk Adjustment and Quality Product Management to provide solution enhancements and inform the organization

What are the requirements needed for this position?

  • 5+ years of experience with implementing, supporting, and/or selling Risk Adjustment solutions required
  • Consulting experience within Health Plans is essential; experience with claims processing, health plan policy, regulatory compliance, or payment innovation is a must
  • Extensive experience within the Risk Adjustment space
  • Working industry knowledge of Risk and Population Health
  • Sales, Consulting, or other Customer Engagement skills

What other skills/experience would be helpful to have?

  • Knowledge of clinical application implementation practices in the healthcare payer industry.
  • Ability to build relationships and motivate cross-functional teams to achieve results in a self-empowered environment
  • Exhibits an innovative, solutioning type mindset
  • Excellent communication skills (verbal and written) enabling effective communication both internally with all areas of the business and externally at prospect/customer staff, managerial, and executive levels.
  • Must interface effectively with all levels of management as well a diverse technical team.
  • Ability to identify gaps in process and provide guidance towards process improvement
  • Demonstrated proficiency with various software applications, including but not limited to: MS Word; MS Excel; MS Access; Visio; JIRA; SharePoint with MS project a plus.
  • Highly collaborative, self-starter; active, problem solver and adult learner
  • Excellent organizational and time management skills.
  • Ability to work in a fast-paced environment; be flexible and responsive to adapt to significant amounts of change

What are the working conditions and physical requirements of this job?

General office demands

How much should I expect to travel?

Up to 20%.


Join our team today where we are creating a better coordinated, increasingly collaborative, and more efficient healthcare system!

COVID Vaccination Requirements

We remain committed to doing our part to ensure the health, safety, and well-being of our team members and our communities. As such, we require all employees to disclose COVID-19 vaccination status prior to beginning employment and we may require periodic testing for certain roles. In addition, some roles require full COVID-19 vaccination as an essential job function. Change Healthcare adheres to COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance.

Equal Opportunity/Affirmative Action Statement

Change Healthcare is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, genetic information, national origin, disability, or veteran status. To read more about employment discrimination protections under federal law, read EEO is the Law at https://www.eeoc.gov/employers/eeo-law-poster and the supplemental information at https://www.dol.gov/ofccp/regs/compliance/posters/pdf/OFCCP_EEO_Supplement_Final_JRF_QA_508c.pdf.

If you need a reasonable accommodation to assist with your application for employment, please contact us by sending an email to applyaccommodations@changehealthcare.comwith "Applicant requesting reasonable accommodation" as the subject. Resumes or CVs submitted to this email box will not be accepted.

Click here https://www.dol.gov/ofccp/pdf/pay-transp_%20English_formattedESQA508c.pdfto view our pay transparency nondiscrimination policy.

California (US) Residents: By submitting an application to Change Healthcare for consideration of any employment opportunity, you acknowledge that you have read and understood.

Change Healthcare maintains a drug free workplace and conducts pre-employment drug-testing, where applicable, in accordance with federal, state and local laws.


Job Summary
Start Date
As soon as possible
Employment Term and Type
Regular, Full Time
Required Experience
5+ years
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