M
Vice President - Product, Assessment Solutions (Risk Adjustment & Quality)
Remote
Job Description
Overview
VP - Product, Assessment Solutions (Risk Adjustment & Quality)
(Remote)
About Us
Matrix Medical Network is the nation’s leading independent provider of comprehensive in-home health assessments, serving Medicare Advantage, Managed Medicaid and Commercial patients across all 50 states. With a network of 3,000 + clinicians, we deliver personalized Whole Person Care that includes diagnostic testing, risk identification, medication management and preventive health education, empowering people to better manage acute and chronic conditions.
Guided by our mantra- We see you. We hear you. We’ve got you.- and our core values of Integrity, Accountability, Trust, Respect and Passion, we are committed to creating a culture where both patients and teammates feel valued, supported and heard.
Responsibilities
About the Role:
- Type: Full-Time, Salaried
- Compensation: $245K (target base salary)
- Location: Fully Remote (must be located in the United States)
- Hours: Full-Time, Days
- Benefits Offered: Medical, dental, vision, paid time off, paid holidays, 401(k) with company matching, voluntary life insurance, short-term disability, long-term disability, employee assistance program, health savings account, flexible spending accounts, and additional voluntary benefits.
The Vice President for Assessment Solutions (Risk Adjustment & Quality) owns the end-to-end strategy, P&L and outcomes for Matrix’s assessment-based Risk Adjustment & Quality business (e.g., Comprehensive Health Assessments and quality gap closure programs). You will be the single-threaded owner for this product line—setting priorities, making tradeoffs and delivering measurable financial and clinical performance. This role sits in Product and partners closely with Operations, Clinical, Data & Analytics, Commercial and Account Management.
Key Responsibilities
Strategic Leadership
- Set the multi-year strategy, roadmap, and annual operating plan for the Risk Adjustment & Quality portfolio; own revenue growth, contribution margin and capital allocation.
- Act with clear decision-making authority, informed by stakeholder input and organizational guardrails.
- Decide where to play and how to win across MA, Medicaid and ACA; define market segmentation, packaging, and pricing (e.g., PMPM, per-assessment, shared savings).
- Anticipate market and regulatory shifts (CMS/HHS/state Medicaid, Stars/HEDIS) and translate them into competitive differentiation and compliant delivery.
- Own full financial performance, including revenue growth, margin optimization, and long-term business sustainability. Drive investment decisions, resource allocation and commercialization strategies to ensure profitability and competitive differentiation.
- Identify and capture new growth opportunities in payer, provider and employer markets. Develop go-to-market strategies and pricing models that expand market share and position Matrix as a leader in risk adjustment and gap closure.
- Ensure operating models, delivery workflows, and partnerships scale efficiently with business growth. Drive cost optimization and operational performance alongside product innovation.
- Serve as executive sponsor in client engagements, representing the strategy and results of the business line.
- Translate client and market input into actionable initiatives that grow retention, adoption, and expansion.
- Partner with Commercial teams to position Risk Adjustment & Gap Closure as a core differentiator in the Matrix portfolio.
- Foster a culture of accountability, client empathy, and innovation.
- Establish best practices across teams to create cross-functional alignment.
- Collaborate with Engineering, Data & Analytics, and Operations to deliver scalable, high-quality client solutions.
- Align with Compliance, Legal and Clinical teams to ensure solutions meet industry, regulatory, and contractual standards.
- Partner with Marketing to develop client-facing product communications and adoption strategies.
- Define and monitor KPIs to drive excellence within the business and prioritize opportunities for growth.
- Use data and market insights to prioritize roadmap decisions and strengthen value delivery.
- Create frameworks to proactively identify and resolve friction points in the value delivery stream.
Experience:
- 10+ years in health plan or payer-services roles spanning Risk Adjustment and Quality/Stars across MA, Medicaid, and ACA—with direct accountability for performance (not advisory only).
- Demonstrated success owning strategy and outcomes for a business line or P&L.
- Deep expertise in value drivers for Medicare Advantage, Medicaid, and ACA payers.
- Experience with CMS programs, Stars/HEDIS and value-based care models.
- Firsthand experience in risk adjustment coding and clinical operations: ICD-10-CM/HCC guidelines, documentation integrity, coding QA/second-level review, RAF mechanics, chart retrieval & submission, RADV/audit readiness and end-to-end assessment workflows (scheduling → completion → coding).
- Bachelor’s degree required; MBA, MPH or related advanced degree preferred.
- Builder-operator mindset with clear decision rights and bias to measurable outcomes; expertise in enterprise product strategy and execution.
- Excellent leadership and collaboration skills across clinical, operations, sales, client management and product teams.
- Strong executive presence and communication skills to engage with C-level executives and drive alignment across diverse stakeholders.
- High emotional intelligence, business acumen and passion for excellence in healthcare.
- Experience supporting payer, provider or large employer clients.
- Deep experience in Medicare Advantage, Medicaid or value-based care models.
- Bilingual or multicultural client experience is a plus.
- Certifications in product management or client success frameworks are a plus.
- Demonstrated profitability improvements, ROI on product and operational investments, and contribution to enterprise financial and strategic goals.
- Strong client satisfaction, retention, and growth rates.
- Remote role with periodic travel for client meetings, team collaboration and field insights.
- Fast-paced, mission-driven and collaborative culture focused on measurable impact and long-term partnerships.
- We have a clear vision of where we are going, and we are guided by core values that embody our organization and our culture.
- We emphasizes innovation and growth, and you will be given the opportunities and tools to develop personally and professionally.
- We encourage and celebrate collaboration.
- We have a deep commitment to positively impact the communities in which we work and to make a difference in the lives of who we serve.
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