Job Description
We are seeking a strategic, client-facing leader to manage our most complex enterprise relationships while also owning the strategy and execution of our quality improvement programs. This is a hybrid role for someone equally comfortable serving as a trusted executive partner to enterprise clients and driving measurable outcomes on HEDIS, STAR, and other clinical quality measures.
Job Description
Key Responsibilities
Enterprise Account Management
- Lead and manage trusted enterprise relationships, acting as the primary point of contact for inquiries and escalations from key decision-makers, aligning product value with business goals to ensure long-term strategic alignment.
- Oversee the complex customer lifecycle from strategic onboarding through retention, providing technical support, addressing inquiries, resolving issues, and ensuring product functionality meets specifications.
- Serve as the voice of the customer, collaborating with Product and Engineering teams on product reliability and feedback for improvements based on enterprise client needs.
- Provide consultative leadership, leveraging a proven track record managing the company's largest, most complex books of business to influence stakeholders across Operations, Legal, and Product/Engineering.
- Pioneer and execute expansion strategies, independently identifying and securing upsell and cross-sell opportunities to maximize satisfaction and retention.
- Drive cross-functional alignment so client success initiatives integrate with and support overall company growth and financial performance.
- Advocate for client interests, representing client needs and feedback internally to ensure the product roadmap reflects market demands.
- Track, analyze, and report on key metrics, including recurring revenue, margins, and satisfaction scores, to identify account risks early and lead complex escalation resolutions with data-backed updates.
Quality Improvement Programs
- Lead and oversee cross-functional initiatives focused on identifying and closing care gaps, improving member engagement, and delivering measurable outcomes for health plan and employer clients.
Strategy
- Develop, optimize, and execute gap closure plans.
- Establish annual quality improvement objectives and performance targets.
- Lead cross-functional teams to deliver measurable outcomes.
Program Operations
- Design and implement member outreach campaigns.
- Manage workflows supporting HEDIS and STAR initiatives.
- Optimize operational processes to improve completion rates and efficiency.
- Stand up a repeatable playbook for new quality measures as CMS/NCQA requirements shift.
Analytics & Reporting
- Build KPI dashboards and executive reporting.
- Monitor performance trends and identify opportunities for improvement.
- Turn outreach and completion data into specific, actionable recommendations each quarter.
Client Management
- Serve as executive liaison for quality initiatives.
- Present results and recommendations to senior client leadership.
- Support business development efforts and solution design.
Process Improvement
- Develop scalable and repeatable operational processes.
- Identify technology enhancements and automation opportunities.
- Implement best practices and continuous improvement methodologies.
Financial Management
- Develop business cases and ROI models.
- Manage program budgets and vendor relationships.
Required Experience & Qualifications
Minimum Qualifications:
- Bachelor's degree required.
- 5+ years of experience in Healthcare Operations or Customer Success, preferably within digital healthcare or pharmacy.
- 3+ years leading HEDIS, STARS, population health, or quality improvement programs.
- Proven success in complex healthcare client management, including confident management of relationships with C-suite executives.
- Deep understanding of NCQA and CMS quality measures.
- Strong technical expertise or aptitude for understanding and troubleshooting complex systems and applications.
- Superb communication and interpersonal skills, with the ability to build, maintain, and influence strong relationships with high-stakes internal and external stakeholders, including senior client leadership.
- Strategic thinker with a customer-centric approach and the ability to understand program and process impact across the entire organization.
- Strong analytical mindset, with proficiency in data analysis and problem-solving to identify trends and inform executive decision-making.
- Experience leading cross-functional teams in a matrixed environment.
- Ability to thrive in a fast-paced, dynamic environment, effectively managing multiple high-priority enterprise accounts and competing interests.
Required Experience
- Direct experience closing HEDIS or STAR care gaps at scale (population health management)
- Experience designing or running member outreach campaigns (call center, SMS, digital, or mail-based)
- Experience managing contract renewals, SLAs, or escalations with enterprise health plan or employer clients
- Familiarity with quality measure lifecycle management (measure retirement, specification updates, new measure rollout)
- Experience navigating both the clinical/quality side and the commercial/account side of a healthcare business
Additional Information
Additional Physical Job Requirements
Physical requirements for this role include the ability to work at a computer terminal with monitor, keyboard and mouse for extended periods of time, stoop, bend, and reach for equipment and supplies, make frequent repetitive motions required to operate a computer that include the wrists, hands and fingers, and lift, carry, push, pull, and move light objects up to 20 pounds. The role also requires the ability to effectively communicate through verbal interactions, discern auditory information, and visually perceive details to perform essential job functions.
Salary and Benefits
Salary Range: $108,800.00 to $136,000.00
Commission Eligible: Yes
Travel: Yes
Location Requirement:
- Fuze Health is limited to individuals residing in the following states: Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Vermont, Virginia, Washington (WA), Wisconsin
Employment Authorization Requirement: Applicants must be authorized to work for any employer in the U.S. Alto Pharmacy, Fuze Health, LetsGetChecked, and Fuze Care Services can not take over, transfer, or sponsor any visa type at this time.
Benefits - Fuze Health
Full-time employee benefits include: dental, vision, and multiple group medical plans to choose from, a 401(k) retirement savings plan, group life insurance, accidental death and dismemberment (AD&D) insurance, flexible spending account (FSA) and health savings account (HSA), commuter benefits, employer-paid short-term (STD) and long-term disability (LTD) insurance, and additional supplemental insurance plans (spouse life insurance, legal insurance, an employee assistance program, home health testing kits, and a fertility medication discount program). Employees are also provided flexible vacation time, accrued paid sick time, 10 paid holidays, (2 floating holidays for full time non-exempt employees) , and eight weeks of paid parental leave for eligible employees, additional paid weeks for the birthing parent, 4 weeks paid caregiver leave, and a Lifestyle Spending Account allowance each month.
More Benefits Information Here:
The application deadline is November 8th. This application deadline may be extended based on business needs.
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