Overview
The Senior Solutions Consultant serves as Cotiviti’s subject matter expert and “voice of product” for our consumer engagement solutions and broader Health Enablement offerings. This role partners closely with Sales, Product, and Client teams to pursue strategic opportunities, deliver compelling demonstrations, and provide deep expertise on member and provider engagement, intervention planning, and healthcare activation workflows.
The Senior Solutions Consultant bridges the gap between customer needs and product capabilities, ensuring Cotiviti’s consumer engagement solutions address real-world health plan challenges and support measurable outcomes across risk adjustment, quality improvement, member engagement, and population health initiatives.
Responsibilities
Pre-Sales Support & Customer Engagement
- Partner with Sales on strategic opportunities involving consumer engagement, intervention planning, outreach, and Health Enablement solutions.
- Lead product demonstrations showcasing member and provider engagement workflows, outreach analytics, and integrated risk and quality engagement strategies.
- Present to health plan executives, risk adjustment leaders, quality teams, care management teams, and client stakeholders.
- Conduct discovery sessions to understand customer operational challenges, engagement strategies, outreach gaps, and business goals.
- Support pilot and proof-of-concept initiatives to demonstrate solution value and operational outcomes.
- Assist with pricing, scoping, and solution positioning discussions for strategic opportunities.
RFP & Proposal Support
- Develop technical and operational content for engagement and outreach-focused RFP responses.
- Present solutions during finalist presentations with focus on operational outcomes, member/provider engagement effectiveness, and integrated risk and quality workflows.
- Support implementation scoping and level-of-effort estimates for complex engagements.
- Assist in developing client-facing presentations, value stories, and sales enablement materials.
Market Intelligence & Product Feedback
- Capture customer feedback on product capabilities, workflow gaps, and enhancement priorities.
- Monitor competitive landscape across engagement, intervention planning, and healthcare activation solutions.
- Communicate market trends, client feedback, and operational insights to Product Management.
- Contribute to sales enablement materials, case studies, webinars, and competitive positioning.
- Support go-to-market initiatives and launch readiness activities for new engagement capabilities.
Subject Matter Expertise
- Maintain deep expertise in member and provider engagement strategies, outreach operations, and intervention planning workflows.
- Understand healthcare payer operations across Risk Adjustment, Quality Improvement, Stars, and care gap closure initiatives.
- Stay current on market trends related to healthcare engagement, digital outreach, and population health management.
- Develop and deliver training for Sales and Account teams on consumer engagement solution capabilities.
- Act as a subject matter expert during client calls, strategic discussions, and industry-facing engagements.
- Complete all responsibilities as outlined in the annual performance review and/or goal setting.
- 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 in Healthcare Administration, Business, or related field.
- 10+ years of experience in healthcare technology, risk adjustment operations, or health plan consulting.
- Deep knowledge of Medicare Advantage retrospective risk adjustment programs and operations.
- Experience in pre-sales, solution consulting, or customer-facing product roles.
- Strong presentation and demonstration skills with executive audiences.
- Ability to translate complex technical capabilities into business value propositions.
- Excellent written communication skills for RFP responses and technical documentation.
- Willingness to travel up to 25% for customer meetings and industry events.
Preferred Qualifications
- Prior role in health plan risk adjustment or revenue optimization operations.
- Familiarity with medical record retrieval, HCC coding, and encounter data submission.
- Understanding of Commercial and Medicaid risk adjustment models.
- Experience with healthcare analytics platforms and data visualization to.
Cognitive/Mental Requirements
- Ability to analyze complex information and communicate it clearly to diverse audiences.
- Strong critical thinking, problem solving, and decision-making skills.
- Capacity to manage multiple proprieties and maintain attention to detail.
- Effective memory and recall to stay current on solution knowledge and industry practices.
- Mental flexibility to adapt communication style and approach to different situations.
- Ability to remain composed and think quickly under pressure.
- Strong organizational and planning skills to support client engagements and sales activities.
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 high-speed internet access / connectivity and office setup and maintenance.
- Must be able to provide a dedicated, secure work area.
Base compensation ranges from $140,000 to $175,000 per year. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs. This role is eligible for discretionary bonus consideration.
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.
Date of posting: 6/1/2026
Applications are assessed on a rolling basis. We anticipate that the application window will close on 8/1/2026, 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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