Document:

EX-10.20

 Exhibit 10.20 

Accretive Health, Inc. 

Nonstatutory Stock Option Award Agreement 

GENERAL TERMS AND CONDITIONS 
 This Nonstatutory Stock
Option Award is granted to the Participant on a stand-alone basis, outside the Accretive Health, Inc. 2010 Stock Incentive Plan (the “Plan”), as a material inducement for the Participant to accept the position of Chief Operating
Officer of the Company and enter into the Offer Letter Agreement with the Company dated April 27, 2013 (the “Offer Letter Agreement”). Notwithstanding the foregoing, it is intended that all of the terms and conditions of the
Plan that would otherwise have been applicable to this Nonstatutory Stock Option Award had this Nonstatutory Stock Option Award been granted under the Plan (except as otherwise expressly provided herein) be applicable to this Nonstatutory Stock
Option Award, and accordingly, references to the Plan are made herein for such purpose and those terms are incorporated herein by reference. The Plan is attached as Exhibit 10.23 to Amendment No. 4 to the Company’s Registration Statement
on Form S-1/A filed with the Securities and Exchange Commission on April 26, 2010. 
 For valuable consideration, receipt of which is acknowledged, the
parties hereto agree as follows: 
 1. Grant of Option. 

This Nonstatutory Stock Option Award Agreement (this “Agreement”) evidences the grant by the Company, on June 3, 2013
(the “Grant Date”), to the Participant, an employee of the Company, of an option to purchase, in whole or in part, on the terms provided herein and in the Plan, 800,000 shares (the “Shares”) of common stock, $0.01
par value per share, of the Company (“Common Stock”) at an exercise price of $11.47 (the “Exercise Price”). Unless earlier terminated, this option shall expire at 5:00 p.m., Eastern time, on the tenth anniversary of
the Grant Date (the “Final Exercise Date”). 
 It is intended that the option evidenced by this agreement shall not be an
incentive stock option as defined in Section 422 of the Internal Revenue Code of 1986, as amended, and any regulations promulgated thereunder (the “Code”). Except as otherwise indicated by the context, the term
“Participant”, as used in this option, shall be deemed to include any person who acquires the right to exercise this option validly under its terms. 

2. Vesting Schedule. 

(a) General. Except as provided in Sections 2(a) and 2(b) hereof, beginning on the first monthly anniversary of the Grant Date, and
continuing for as long as the Participant is employed by the Company, this option shall become vested, and exercisable, on a ratable monthly basis over forty eight (48) months with respect to the shares of Common Stock issuable hereunder, and
thus shall become fully vested and exercisable as to all such Shares no later than the fourth anniversary of the Grant Date, subject to the Participant’s continued employment with 

 
the Company on each applicable vesting date. The right of exercise hereunder shall be cumulative so that to the extent that the option is not exercised in any period to the maximum extent
permissible it shall continue to be exercisable, in whole or in part, with respect to all Shares for which it is vested until the earlier of the Final Exercise Date and the termination of this option under Section 3 hereof or the Plan. 

(b) Termination Without Cause or For Good Reason Prior to First Anniversary of Grant Date. Notwithstanding the provisions of
Section 2(a) hereof, in the event of the Participant’s termination of employment by the Company without “Cause” or by the Participant for “Good Reason” (each, as defined in the Offer Letter Agreement), in either case,
prior to the first anniversary of the Grant Date, any unvested portion of this option that would have become vested and exercisable on or prior to the first anniversary of the date of such termination had such termination not occurred shall become
vested and exercisable as of the date of such termination, and shall remain exercisable in accordance with the otherwise applicable provisions hereof. 

(c) Change in Control. Notwithstanding the provisions of Sections 2(a) and 2(b) hereof, upon the occurrence of a “Change in
Control” (as defined below) while the Participant remains in the continued employment of the Company, fifty percent (50%) of the unvested portion of this option outstanding at the time of such Change in Control shall become immediately
vested and exercisable upon the occurrence of such Change in Control, and shall remain exercisable in accordance with the otherwise applicable provisions hereof. In addition to the foregoing, in the event of the Participant’s termination of
employment by the Company without Cause or by the Participant for Good Reason, in either case, upon or within one (1) year following the occurrence of a Change in Control, any unvested portion of this option outstanding at the time of such
termination shall become vested and exercisable as of the date of such termination, and shall remain exercisable in accordance with the otherwise applicable provisions hereof. 

For purposes hereof, the term “Change in Control” means: (i) any “person”, as such term is used as of the
Grant Date in Section 13(d) of the Securities Exchange Act of 1934, as amended, or group of persons, becomes (directly or indirectly) a “beneficial owner”, as such term is used as of the Grant Date in Rule 13d-3 promulgated under that
Securities Exchange Act of 1934, as amended, of a percentage of the outstanding voting securities of the Company (measured either by number of outstanding voting securities or by voting power) equal to at least fifty percent (50%) of the
outstanding voting securities of the Company; (ii) a majority of the members of the Board of Directors of the Company consists of individuals other than “Incumbent Directors,” which term means the members of such Board of
Directors on the Grant Date; provided that any individual becoming a director subsequent to such date whose election or nomination for election was supported (other than in connection with any actual or threatened proxy contest) by two-thirds
of the directors who then comprised the Incumbent Directors will be considered to be an Incumbent Director; or (iii) (A) the Company combines with another entity and is the surviving entity, or (B) all or substantially all of the
assets or business of the Company is disposed of pursuant to a sale, merger, consolidation, liquidation, dissolution or other transaction or series of transactions (collectively, a “Triggering Event”), unless the holders of the
Company’s outstanding voting securities immediately prior to such Triggering Event own, 

 
directly or indirectly, by reason of their ownership of the Company’s outstanding voting securities immediately prior to such Triggering Event, more than fifty percent (50%) of the
outstanding voting securities (measured both by number of outstanding voting securities and by voting power) of (x) in the case of a combination in which the Company is the surviving entity, the surviving entity, and (y) in any other case,
the entity (if any) that succeeds to substantially all of the Company’s business and assets. 
 3. Exercise of Option. 

(a) Form of Exercise. Each election to exercise this option shall be in writing, signed by the Participant, and received by the Company
at its principal office, accompanied by this agreement, and payment in full in the manner provided in the Plan. Alternatively, the exercise can be effected using the software solution provided by the Company’s option management software vendor,
with payment in full in the manner provided in the Plan. The Participant may purchase less than the number of shares covered hereby, provided that no partial exercise of this option may be for any fractional share. No Shares will be issued until the
Participant has executed any and all agreements that the Company may require the Participant to execute in connection with such exercise and/or in connection with any transactions involving the Shares (for example, not by limitation, lock-up
agreements and FINRA questionnaires). 
 (b) Continuous Relationship with the Company Required. Except as otherwise provided in this
Section 3, this option may not be exercised unless the Participant, at the time he exercises this option, is, and has been at all times since the Grant Date, an employee or officer of or consultant or advisor to, the Company or any other entity
the employees, officers, directors, consultants, or advisors of which are eligible to receive option grants under the Plan (an “Eligible Participant”). 

(c) Termination of Relationship with the Company. If the Participant ceases to be an Eligible Participant for any reason, then, except
as provided in paragraph (d) below, the right to exercise this option shall terminate sixty (60) days after such cessation (but in no event after the Final Exercise Date), provided that this option shall be exercisable only to the
extent that the Participant was entitled to exercise this option on the date of such cessation. Notwithstanding the foregoing, if the Participant, prior to the Final Exercise Date, violates the non-competition or confidentiality provisions of any
employment contract, confidentiality and nondisclosure agreement or other agreement between the Participant and the Company, including the provisions of Section 6 of this Agreement, the right to exercise this option shall terminate immediately
upon such violation. 
 (d) Termination for Cause. If, prior to the Final Exercise Date, the Participant’s employment or other
relationship with the Company is terminated by the Company for “Cause” (as defined in the Offer Letter Agreement), the right to exercise this option shall terminate immediately upon the effective date of such termination of employment or
other relationship. The Participant’s employment or other relationship shall be considered to have been terminated for “Cause” if the Company determines, within thirty (30) days after the Participant’s resignation, that
termination for Cause was warranted. In the event that the Participant is terminated for Cause, the Company shall be entitled to pursue the remedies set forth in Section 6(h) of this Agreement. 

 4. Withholding. 

No Shares will be issued pursuant to the exercise of this option unless and until the Participant pays to the Company, or makes provision
satisfactory to the Company for payment of, any federal, state or local withholding taxes required by law to be withheld in respect of this option. 

5. Transfer Restrictions. 

This option may not be sold, assigned, transferred, pledged or otherwise encumbered by the Participant, either voluntarily or by operation of
law, except by will or the laws of descent and distribution, and, during the lifetime of the Participant, this option shall be exercisable only by the Participant. 

6. Restrictive Covenants. 

(a) General. This option represents a substantial economic benefit to the Participant. The Participant, by virtue of such
Participant’s role with the Company, has access to, and is involved in the formulation of, certain confidential and secret information of the Company regarding its operations and each Participant could materially harm the business of the
Company by competing with the Company or soliciting employees or customers of the Company. 
 (b) Non -Solicitation. During the time
in which Participant performs services for the Company and for a period of eighteen (18) months after the Participant ceases to perform services for the Company, regardless of the reason, Participant shall not, directly or indirectly, either
alone or in conjunction with any person, firm, association, company or corporation: 
 (i) Hire, recruit, solicit or otherwise attempt to
employ or retain or enter into any business relationship with, any person who is or was an employee of the Company within the twelve (12)-month period immediately preceding the cessation of Participant’s service with the Company; or 

(ii) Solicit the sale of any products or services that are similar to or competitive with products or services offered by, manufactured by,
designed by, or distributed by the Company, to any person, company or entity which was or is a customer or potential customer of the Company for such products or services. 

(c) Non-Disclosure. 
 (i)
Participant will not, without the Company’s prior written permission, directly or indirectly, utilize for any purpose other than for a legitimate business purpose solely on behalf of the Company, or directly or indirectly, disclose to anyone
outside of the Company, either during or after Participant’s relationship with the Company ends, the Company’s Confidential Information, as long as such matters remain Confidential Information. 

 (ii) This Agreement shall not prevent Participant from revealing evidence of criminal wrongdoing
to law enforcement or prohibit Participant from divulging the Company’s Confidential Information by order of a court or agency of competent jurisdiction. However, Participant shall promptly inform the Company of any such situations and shall
take such reasonable steps to prevent disclosure of the Company’s Confidential Information until the Company has been informed of such requested disclosure and the Company has had an opportunity to respond to the court or agency. 

(d) Return of Company Property. Participant agrees that, in the event that Participant’s service to the Company is terminated for
any reason, Participant shall immediately return all of the Company’s property, including, without limitation, (i) tools, pagers, computers, printers, key cards, documents or other tangible property of the Company, and (ii) the
Company’s Confidential Information in any media, including paper or electronic form, and Participant shall not retain in Participant’s possession any copies of such information. 

(e) Ownership of Software and Inventions. All discoveries, designs, improvements, ideas, inventions, software, whether patentable or
copyrightable or not, shall be works-made-for-hire and the Company shall be deemed the sole owner throughout the universe of any and all rights of whatsoever nature therein, with the rights to use the same in perpetuity in any manner the Company
determines in its sole discretion without any further payment after the term of the agreement to Participant whatsoever. If, for any reason, any of such results and proceeds which relate to the business shall not legally be a work-for-hire and/or
there are any rights which do not accrue to the Company under the preceding sentence, then Participant hereby irrevocably assigns and agrees to quitclaim any and all of the Participant’s right, title and interest thereto including, without
limitation, any and all copyrights, patents, trade secrets, trademarks and/or other rights of whatsoever nature therein, whether or not now or hereafter known, existing, contemplated, recognized or developed to the Company, and the Company shall
have the right to use the same in perpetuity throughout the universe in any manner the Company determines without any further payment to Participant whatsoever. The Participant shall, from time to time, as may be reasonably requested by the Company,
at the Company’s expense, do any and all things which the Company may deem useful or desirable to establish or document the Company’s exclusive ownership of any and all rights in any such results and proceeds, including, without
limitation, the execution of appropriate copyright and/or patent applications or assignments. To the extent Participant has any rights in the results and proceeds of Participant’s services that cannot be assigned in the manner described above,
Participant unconditionally and irrevocably waives the enforcement of such rights. Notwithstanding anything to the contrary set forth herein, works developed by the Participant (i) which are developed independently from the work developed for
the Company regardless of whether such work was developed before or after the Participant performed services for the Company; or (ii) applications independently developed which are unrelated to the business and which Participant develops during
non-business hours using non-business property shall not be deemed work for hire and shall not be the exclusive property of the Company. 

 (f) Non-Competition. 

(i) During the time in which Participant performs services for the Company and for a period of twelve (12) months after the cessation of
Participant’s service to the Company, regardless of the reason, Participant shall not, directly or indirectly, either alone or in conjunction with any person, firm, association, company or corporation, within the Restricted Area, own, manage,
operate, or participate in the ownership, management, operation, or control of, or be employed by or provide services to, any entity which is in competition with the Company. 

(ii) Notwithstanding anything to the contrary, nothing in this paragraph (f) prohibits Participant from being a passive owner of not more
than one percent (1%) of the outstanding stock of any class of a corporation which is publicly traded, so long as Participant has no active participation in the business of such corporation. 

(g) Acknowledgments. Participant acknowledges and agrees that the restrictions contained in this Agreement with respect to time,
geographical area and scope of activity are reasonable and do not impose a greater restraint than is necessary to protect the goodwill and other legitimate business interests of the Company and that the Participant has had the opportunity to review
the provisions of this Agreement with his legal counsel. In particular, the Participant agrees and acknowledges (i) that the Company is currently engaging in business and actively marketing its services and products throughout the United
States, (ii) that Participant’s duties and responsibilities for the Company are co-extensive with the entire scope of the Company’s business, (iii) that the Company has spent significant time and effort developing and protecting
the confidentiality of their methods of doing business, technology, customer lists, long term customer relationships and trade secrets, and (iv) that such methods, technology, customer lists, customer relationships and trade secrets have
significant value. 
 (h) Enforcement. The Participant agrees that the restrictions contained in this Agreement are necessary for the
protection of the business, the Confidential Information, customer relationships and goodwill of the Company and are considered by the Participant to be reasonable for that purpose and that the scope of restricted activities, the geographic scope
and the duration of the restrictions set forth in this Agreement are considered by the Participant to be reasonable. The Participant further agrees that any breach of any of the restrictive covenants in this Agreement would cause the Company
substantial, continuing and irrevocable harm for which money damages would be inadequate and therefore, in the event of any such breach or any threatened breach, in addition to such other remedies as may be available, the Company shall be entitled
to specific performance and injunctive relief. This Agreement shall not in any way limit the remedies in law or equity otherwise available to the Company or its Affiliates. The Participant further agrees that to the extent any provision or portion
of the restricted covenants in this Agreement shall be held, found or deemed to be unreasonable, unlawful or unenforceable by a court of competent jurisdiction, then any such provision or portion thereof shall be deemed to be modified to the extent
necessary in order that any such provision or portion thereof shall be legally enforceable to the fullest extent permitted by applicable law. Without limitation to any other remedies available hereunder or at law, in the event of any breach of any
of the restrictive covenants in this Agreement by the Participant, the Participant agrees that any Shares purchased 

 
by the Participant pursuant to this Agreement shall be subject to repurchase by the Company, in its sole discretion, at a price equal to the lesser of the Exercise Price and the Fair Market Value
of the Shares at the time of repurchase. In the event that the Participant sold the Shares purchased by the Participant pursuant to this Agreement, then the Participant shall be required to pay to the Company in cash, within thirty (30) days of
a request by the Company for such payment, the positive difference, if any, between the price at which the Participant sold the Shares and the amount at which the Company could have repurchased the Shares pursuant to the preceding sentence. 

(i) Severability; Modification. It is expressly agreed by Participant that: 

(i) Modification. If, at the time of enforcement of this Agreement, a court holds that the duration, geographical area or scope of
activity restrictions stated herein are unreasonable under circumstances then existing or impose a greater restraint than is necessary to protect the goodwill and other business interests of the Company, Participant agrees that the maximum duration,
scope or area reasonable under such circumstances will be substituted for the stated duration, scope or area and that the court will be allowed to revise the restrictions contained herein to cover the maximum duration, scope and area permitted by
law, in all cases giving effect to the intent of the parties that the restrictions contained herein be given effect to the broadest extent possible. 

(ii) Severability. Whenever possible, each provision of this Agreement will be interpreted in such manner as to be effective and valid
under applicable law, but if any provision of this Agreement is held to be invalid, illegal or unenforceable in any respect under applicable law, such invalidity, illegality or unenforceability will not affect any other provision, but this Agreement
will be reformed, construed and enforced as if such invalid, illegal or unenforceable provision had never been contained herein. 
 (iii)
Non-Disparagement. Participant understands and agrees that Participant will not disparage the Company, its officers, directors, administrators, representatives, employees, contractors, consultants or customers and will not engage in any
communications or other conduct which might interfere with the relationship between the Company and its current, former, or prospective employees, contractors, consultants, customers, suppliers, regulatory entities, and/or any other persons or
entities. 
 (j) Definitions. 

(i) Affiliate. “Affiliate” means any entity controlling or controlled by or under common control with the Company or another
Affiliate, at the time of execution of this Agreement and any time thereafter, where “control” is defined as the ownership of at least fifty percent (50%) of the equity or beneficial interest of such entity, and any other entity with
respect to which the Company has significant management or operational responsibility (even though the Company may own less than fifty percent (50%) of the equity of such entity). 

 (ii) Confidential Information. “Confidential Information” as used in this
Agreement shall include the Company’s trade secrets as defined under Illinois law, as well as any other information or material which is not generally known to the public, and which: 

a) is generated, collected by or utilized in the operations of the Company’s business and relates to the actual or anticipated business,
research or development of the Company; or 
 b) is suggested by or results from any task assigned to Participant by the Company or work
performed by Participant for or on behalf of the Company. 
 Confidential Information shall not be considered generally known to the public if Participant
or others improperly reveal such information to the public without the Company’s express written consent and/or in violation of an obligation of confidentiality to the Company. Examples of Confidential Information include, but are not limited
to, all customer, client, supplier and vendor lists, budget information, contents of any database, contracts, product designs, technical know-how, engineering data, pricing and cost information, research and development work, software, business
plans, proprietary data, projections, market research, perceptual studies, strategic plans, marketing information, financial information (including financial statements), sales information, training manuals, employee lists and compensation of
employees, and all other competitively sensitive information with respect to the Company, whether or not it is in tangible form, and including without limitation any of the foregoing contained or described on paper or in computer software or other
storage devices, as the same may exist from time to time. 
 (iii) Restricted Area. For purposes of this Agreement, the term
“Restricted Area” shall mean the United States of America. 
 7. Applicable Law. 

This Agreement shall be construed, interpreted and enforced, and its validity and enforceability determined, strictly in accordance with the
laws of the State of Delaware without applying its conflicts of laws principles. 
 8. Exclusive Jurisdiction/Venue. 

All disputes that arise from or relate to this Agreement shall be decided exclusively by binding arbitration in Cook County, Illinois under
the Commercial Arbitration Rules of the American Arbitration Association. The parties agree that the arbitrator’s award shall be final, and may be filed with and enforced as a final judgment by any court of competent jurisdiction.
Notwithstanding the foregoing, any disputes related to the enforcement of the restrictive covenants contained in Section 6 of this Agreement shall be subject to and determined under Delaware law and adjudicated in Illinois courts. 

 9. Provisions of the Plan. 

This option is subject to the provisions of the Plan (including the provisions relating to amendments to the Plan), a copy of which is
furnished to the Participant with this option. 
 I hereby acknowledge that I have reviewed this Agreement and agree to comply with the
terms and conditions set forth herein. 
 Grant Date: June 3, 2013 

 

			
	Accretive Health, Inc.
		
	By:	 	 /s/ Daniel Zaccardo

	Name:	 	 Daniel Zaccardo

	Title:	 	 SVP/General Counsel

 

			
	ACCEPTED
	
	PARTICIPANT
	
	 /s/ Joseph Flanagan

	        Joseph FlanaganEX-10.21

 Exhibit 10.21 

Transition Agreement 

1. Parties. This Transition Agreement (the “Agreement”) is between you, on behalf of yourself, your spouse, family,
agents and attorneys (jointly, “You” or “Employee”) and Accretive Health, Inc., on behalf of its parent, subsidiaries, predecessors, successors, affiliates, directors, officers, fiduciaries, insurers, employees and agents
(jointly, “the Company”). 
 2. Separation Date. You have notified Accretive Health of your decision voluntarily to
resign your position with the Company (“Separation”) effective May 31, 2013, or such earlier date that the Company or you decide to terminate the employment relationship (“Separation Date”). The Company reserves the right to
relieve you of some or all of your duties any time before the Separation Date, and provided that you have not engaged in any material misconduct that is reasonably determined by the Company to be likely to harm the Company (including its business,
products, reputation or employees), you will be retained on the Company payroll as an active employee through and including May 31, 2013, eligible for all salary and benefits attendant to such status. 

3. Separation Benefits. If you sign and do not revoke this Agreement, and if on or after your Separation Date you sign and do not
revoke the attached Reaffirmation Agreement, you will continue to receive your current salary and continue to be eligible for your current medical benefits through the earlier of (i) May 31, 2014 and (ii) the date that you accept full
time employment with another employer (the earlier of (i) and (ii) above, the “Severance Stop Date”); provided, however, that the Company shall be under no obligation to provide or pay the cost (or remaining cost) of such
medical benefits if the Company determines in its sole discretion (upon consultation with counsel) that such provision or payment may subject the Company to any penalty, excise or other tax associated with such payment or coverage. The Company is
not currently aware of any penalty, excise or other tax associated with such payment or coverage. In the unlikely event of death or disability suffered by Employee prior to the Severance Stop Date, Company agrees that these benefits will continue
through May 31, 2014 as contemplated above. The Company will also reimburse you for all business expenses incurred by you in connection with your employment prior to the Separation Date in accordance with the Company’s existing expense
reimbursement policies and properly submitted to the Company by June 30, 2013. Reimbursement will be made no later than July 1, 2013. 

4. Continuing Indemnification of Executive. As a former officer of the Company, you will remain entitled to all indemnification
rights and benefits to which you are presently entitled under law as well as any agreement with or insurance policy provided by the Company, including the Company’s directors’ and officers’ insurance, (in accordance with their
applicable terms) at the same levels as active officers of the Company and as otherwise may be provided from time to time to other officers and former officers of the Company. 

5. Equity. In consideration of your past service to the Company and your execution of this Agreement, notwithstanding the terms
of Section 5.8 and any other applicable terms of the Amended and Restated Stock Option Plan, as amended and provided that you execute and effectuate this Agreement and the Reaffirmation Agreement, the Company will extend the period within which
you must exercise your vested options (i.e., options that are vested as of your Separation Date), from 60 days following the Separation Date until the 1-year anniversary of the Separation Date. You acknowledge and agree that, except for Company
shares which you hold free and clear and as otherwise set forth above, upon the Separation you will have no other rights or claims of interest with respect to equity of the Company. 

6. General Release. In exchange for the payment and benefits described in Section 3, you agree not to bring any lawsuit
against and are waiving and releasing all known or unknown claims and causes of action you have or may have, as of the day you sign this Agreement, against the Company arising out of your employment with the Company, including your separation from
employment. The claims you are releasing include, but are not limited to, any and all claims or causes of action for or arising out of: 

  
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 (a) discrimination, harassment, or retaliation on the basis of any characteristic or trait
protected under law (including but not limited to race, color, national origin, sex, sexual orientation, religion, disability, marital or parental status, age, union activity, arrest or conviction record, military or veteran status, source of
income, genetic background or predisposition, or other protected activity), or other denial of protection or benefits under any statute, ordinance, executive order, or regulation (including but not limited to claims under Title VII of the Civil
Rights Act of 1964, the Civil Rights Act of 1991, the Civil Rights Act of 1866, the Age Discrimination in Employment Act (the “ADEA”), the Americans with Disabilities Act, the Fair Labor Standards Act, the Family and Medical Leave Act, the
Workers’ Adjustment and Retraining Notification Act, the Employee Retirement Income Security Act of 1974, the Illinois Human Rights Act, the Illinois Wage Payment and Collection Act, or any other federal, state or local statute, ordinance, or
regulation regarding employment, termination of employment, or discrimination in employment); 
 (b) pay/compensation/benefits, including
attorney fees, bonuses, commissions, costs, compensatory damages, punitive damages, expenses, incentive pay, insurance, interest, paid/unpaid leave/time off, salary, separation/severance pay/benefits, or wages; 

(c) violation of any personnel policies, procedures, handbooks, any covenant of good faith and fair dealing, or any express or implied contract
of any kind; and/or 
 (d) violation of any public policy, statutory or common law of any state relating to employment or personal injury,
including but not limited to claims for wrongful discharge; defamation; invasion of privacy; intentional or negligent infliction of emotional distress; negligence; interference with contract; negligent hiring, retention or supervision; intentional
interference with contract; detrimental reliance; loss of consortium to you or any member of your family; promissory estoppel; detrimental reliance; fraud; impairment/loss of business/economic opportunity. 

5. Exclusions From General Release. Excluded from the General Release above are any claims or rights which cannot be waived by
law, including your right to unemployment/worker compensation, or vested/earned benefits. Also excluded from the General Release is your right to file a charge with an administrative agency or participate in any agency investigation. You are,
however, waiving your right to recover money in connection with any such charge or investigation. You are also waiving your right to recover money in connection with a charge filed by any other individual or by the Equal Employment Opportunity
Commission or any other federal, state or local agency. 
 6. Release Enforcement. You agree that if you make any claim which
you have released and such claim is determined to be barred by this release, or for any other reason you do not win that claim, you will, at the Company’s option (i) pay to the Company the costs, expenses and reasonable attorney’s
fees in defending against such claim or (ii) repay the Company everything the Company gave you for this Agreement, less $100. 
 7.
Confidentiality. You further agree that you will keep all terms of this Agreement confidential until such time as they are made public by the Company, including but not limited to the fact and amount(s) of the payments discussed herein,
except that you may make necessary disclosures to your attorney or tax advisor. The payment and other benefits referenced in Section 3 of this Agreement are conditioned on your keeping the confidentiality promise contained in this Section. You
also acknowledge the Company’s right to enforce this confidentiality provision in any court of competent jurisdiction. You further agree that if you breach this confidentiality provision, the Company will be irreparably harmed as a matter of
law and will be entitled to immediate injunctive relief, plus its reasonable attorneys’ fees incurred in enforcing this provision. 

  
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 8. Non-Disparagement. You agree that you will not comment negatively on the
Company’s business operations, products, reputation, business relationships, or present or future business, or the reputation of any past or present directors, executives, officers, employees, agents or affiliates, parents or subsidiaries of
the Company. The Company agrees that its officers and directors will not comment negatively about you or your efforts on behalf of the Company. The Company agrees that it will notify its officers and directors of this obligation and that it will be
diligent in assuring that this obligation is fulfilled by its officers and directors. You agree that you will not provide comment about the Company to any person or entity, except as required by law or as necessary for you to defend yourself in any
judicial, arbitral or administrative proceeding or in an action alleging breach of this Agreement, and that you will advise the Company of those instances where you are asked to provide comment about the Company from third parties such as research
firms, press representatives and journalists. Should either party be found to have violated this Section, or to have otherwise breached this Agreement, the other party shall be entitled to: (i) recover whatever legal cost it incurs in enforcing
this Agreement, including its reasonable attorney’s fees; (ii) preliminary and permanent injunctive relief; and (iii) any other appropriate legal or equitable relief. 

9. Return of Company Property. On or before your Separation Date, you must promptly return to the Company all Company property
including, but not limited to, Company identification badge, laptop computer, information technology equipment, documents and records, and other property of the Company in your possession or control, and you agree not to keep, transfer or use any
copies or excerpts of the above items, except as may be authorized, in writing, by the Company’s General Counsel. 
 10.
Non-Admissions. The fact and terms of this Agreement are not an admission by the Company of liability or other wrongdoing under any law. 

11. Additional Employee Agreements and Acknowledgments. You also acknowledge and agree that: 

 

	 	(a)	you are competent as a matter of law to enter into this Agreement; 

  

	 	(b)	you are entering into this Agreement knowingly, voluntarily, and with full knowledge of its significance; you have not been coerced, threatened, or intimidated into signing this Agreement; you have been advised by the
Company to consult with counsel of your choice regarding this Agreement and have had an adequate opportunity to so consult; 

  

	 	(c)	you have relied on your own judgment and that of your counsel regarding the consideration for and language of this Agreement; 

  

	 	(d)	you have received all compensation/benefits/leave/time off you are due up through the end of the last payroll period before you sign this Agreement; 

 

	 	(e)	you have not suffered any on-the-job injury for which you have not already filed a claim; 

  

	 	(f)	the payments and other benefits described in Section 3 above constitute valid and sufficient consideration for the promises contained in this Agreement, and exceed the total amounts and benefits that you otherwise
would receive at the end of your employment with the Company; 

  

	 	(g)	the Company’s decision not to enforce this Agreement if you violate it is not a waiver. 

  

	 	(h)	You have been given until May 13, 2013 to decide whether to sign and return this agreement. 

12. Revocation/Payment. After you sign this Agreement and send the signed copy to Daniel A. Zaccardo
(dzaccardo@accretivehealth.com.fax to 312.670.7824), you will have seven (7) days after its date of execution to revoke acceptance, if you change your mind. If you want to revoke acceptance of the Agreement, you must deliver a written
revocation within seven (7) days after you signed it to the Company representative signing below or Jim Kole. This Agreement will not be effective or enforceable until the revocation period has expired. 

  
 Ÿ Page 3 

 13. Entire Agreement. This Agreement, the Reaffirmation Agreement, and the
agreement (or agreements, as applicable) referenced below in this Section 13, constitutes the entire agreement between the parties and supersedes any and all prior representations and agreements, written or oral, expressed or implied. Nothing
contained herein shall supersede the Employee’s obligations set forth in the Confidentiality and Non-Disclosure Agreement, and/or the Proprietary Interests Protection Agreement, as applicable, and the parties remain bound by the terms of those
respective agreements. 
 14. This Agreement, to the extent signed and delivered by means of e-mail, PDF, or a facsimile machine,
shall be treated in all manner and respects as an original agreement or instrument and shall be considered to have the same binding legal effect as if it were the original signed version thereof delivered in person. At the request of any party
hereto, each other party hereto shall re-execute original forms hereof and deliver them to all other parties. No party hereto shall raise the use of e-mail, PDF or a facsimile machine to deliver a signature or the fact that any signature to this
Agreement was transmitted or communicated through the use of e-mail, PDF or a facsimile machine as a defense to the formation of a contract and each such party forever waives any such defense. 

15. Governing Law/Severability. This Agreement, its interpretation, plus all rights and remedies relating to this Agreement,
shall be governed by the laws of the State of Illinois. If any part of this Agreement is found to be invalid, the rest of the Agreement will be enforceable. 
  

					
	Accretive Health Inc.	  		  	
			
	 /s/ Daniel Zaccardo
	  		  	 /s/ Gregory Kazarian

	By: Daniel Zaccardo, General Counsel	  		  	By: Gregory Kazarian
	Date: April 24, 2013	  		  	Date: April 24, 2013

  
 Ÿ Page 4

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