VP, Sales – Risk & Quality
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Job Description
VP Sales growing HealthEdge’s risk adjustment and quality healthcare SaaS revenue. Expanding payer accounts through complex enterprise sales, CMS-aligned solutions, and market strategy.
Responsibilities:
- Help sales and CSEs build and maintain relationships with key decision-makers
- Understand client needs and align current and future solutions with strategic goals
- Assist in developing and executing market-specific sales plans using market insights and competitive intelligence
- Work with Sales and Marketing to design and implement strategic direction for top prospects
- Partner with Sales Operations, Product, Technology, Marketing, and Client Services to identify, scope, and determine key prospects
- Drive new business and expand existing accounts to increase annual recurring revenue
- Sell Risk Adjustment and Quality solutions, including retrospective and prospective Risk Adjustment offerings, STAR ratings, HEDIS, and quality improvement solutions
- Execute the sales process by analyzing client workflows, matching needs to solutions, conducting presentations and demonstrations, negotiating pricing and contracts, closing sales, and updating the CRM
- Help identify, qualify, and pursue new business opportunities and maintain a healthy sales pipeline
- Engage management and executive-level prospects, build relationships, network with associations, and provide solution demonstrations
- Assist with RFI/RFP responses and coordinate with internal product experts
- Collaborate cross-functionally to support onboarding and long-term client satisfaction
- Monitor industry trends, customer challenges, CMS regulatory developments, ODAG/HPMS reporting requirements, and risk adjustment coding trends
- Provide pipeline forecasts, status updates, activity reports, and risk insights to sales leadership and teams
Requirements:
- 15+ years of experience in Risk Adjustment, Stars, HEDIS, and Quality Solutions, preferably in healthcare SaaS/BPaaS or enterprise software solutions
- Demonstrated knowledge of Medicare Advantage, ACA, and/or Managed Medicaid Risk Adjustment strategies, including retrospective and prospective coding programs
- Experience selling or positioning quality improvement solutions tied to CMS requirements, including STAR ratings and HEDIS
- Healthcare subject matter expertise and solid technical knowledge/aptitude with enterprise-class insurance transaction and healthcare management information systems
- Knowledge and experience with the HealthEdge product suite is a plus
- Understanding of BPaaS and SaaS delivery models as applied to risk adjustment outsourcing, with experience addressing health plan build vs. buy considerations
- Proven track record of meeting or exceeding sales targets, with experience managing complex, multi-stakeholder sales processes
- Strong knowledge of the healthcare industry, particularly payer/provider dynamics, risk adjustment, and value-based care
- Excellent presentation, communication, and interpersonal skills
- Exceptional verbal and written communication skills, with the ability to convey complex technical concepts to non-technical audiences
- Strong analytical and problem-solving abilities
- Ability to work independently and travel as needed within the assigned territory
- Ability to work across multiple time zones in a hybrid or remote work environment
- Candidates may be required to undergo a pre-employment criminal background check
Benefits:
- Equal opportunity employer committed to workforce diversity
- Reasonable accommodations for individuals with disabilities
- Remote or hybrid work environment
- Travel as needed within the assigned territory
- Pre-employment criminal background check
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