HealthEdge

VP, Sales (Risk & Quality)

HealthEdge • $233K — $254K *
US-AnywhereRemote in United States
Healthcare
11 - 15 years of experience
Job Overview by Ladders

Qualifications

  • 15+ years experience in Risk Adjustment and Quality Solutions, ideally in healthcare SaaS/BPaaS.
  • Familiarity with CMS requirements such as STAR ratings and HEDIS.
  • Expertise in healthcare management systems with a preference for knowledge of HealthEdge products.
  • Understanding BPaaS and SaaS applications in risk adjustment outsourcing.
  • Proven success in assisting sales teams exceed targets, especially in complex sales processes.
  • Strong knowledge of payer/provider dynamics and value-based care principles.
  • Excellent verbal and written communication skills for conveying technical concepts to diverse audiences.
  • Ability to work independently and commit to travel when necessary.

Responsibilities

  • Assist in maintaining client relationships and aligning solutions with their strategic goals.
  • Collaborate on executing sales strategies and understanding market opportunities.
  • Drive revenue growth in Risk Adjustment and Quality solutions through direct client engagement.
  • Help manage the sales pipeline and explore new business opportunities.
  • Support RFI/RFP management and ensure compliance in documentation.
  • Work cross-functionally with internal teams to improve client onboarding and satisfaction.
  • Monitor market developments and emerging opportunities for strategic positioning.

Benefits

  • Remote work flexibility within the US.
  • Opportunity to work in a hybrid environment with varying time zones.
  • Dynamic, collaborative team culture focused on results.
  • Support for professional development and training in a growing field.
Full Job Description
Overview

We are seeking a dynamic and results-driven Sales Support Executive to join our team, focusing on growing annual recurring revenue, assist maintaining existing Client business and support product evolutionin our Risk Adjustment and Quality business. This role is responsible for Assisting the sales team in directly developing new revenue opportunities, managing key client relationships, anticipating customer needs, and consistently exceeding client service expectations. Reporting to the SVP, Sales, RAQ and part of the HealthEdge Commercial Excellence team, this position will play a critical role in expanding our footprint, improving our product position in the market in the Risk Adjustment and Quality healthcare SaaS/BPaaS market.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

  • Client Relationship Management: Help sales and CSEs build and maintain strong relationships with key decision-makers, understanding their needs and aligning our current and future solutions to their strategic goals.
  • Sales Strategy Execution: Work with product development and leadership to assist Sales and CSEs toDevelop and execute a marketspecific sales plan, leveraging market insights and competitive intelligence to assist in achieving revenue targetsWork with the Sales and Marketing teams to designand implement a strategic direction for top prospects; working with all internal teams to understand market growth potential; partnering closely and effectively with Sales Operations, Product, Technology, Marketing and Client Services in achieving successful identification,scoping and determination of key prospects; regularly working with and meeting with other market leaders, prospects and working to support the sales process and deliver exceptional insight (e.g., remaining informed of their business needs, reinforcing the value provided); Keeping the organization informed of how our solutions to meet current or future prospect needs.
  • Revenue Growth: Drive new business and expand existing accounts to increase annual recurring revenue in the Risk Adjustment and Quality solutions space, focusing on retrospective and prospective Risk Adjustment offerings (SaaS/BPaaS models) and quality improvement solutions tied to CMS requirements, including STAR ratings and HEDIS, across Medicare Advantage, ACA, and Managed Medicaid markets. Complies with and executes the sales process to meet revenue targets and sales quotas by meeting with potential clients face-to-face; discussing, documenting and fully understanding client business needs and goals (e.g., workflow analysis); matching clients' needs with our solutions and service offerings to create opportunities and generate revenue; conducting presentations and demonstrations; negotiating pricing and contract details; finalizing contracts and sales; and updating the CRM database throughout the client development process.
  • Pipeline Management: Help Sale sand Client management identify, qualify, and pursue new business opportunities.. Continuously seeks strategies to support a healthy sales pipeline by reviewing, understanding and communicating what prospects will make good targets, assist Sales and CSEs on opportunities where you may hold an existing relationship ; engaging potential clients at the management and executive level to identify business opportunities; seeking introductions to additional staff (e.g., power users, managers/decision makers, IT, operations); networking and establishing relationships with key prospects and associations to identify additional leads; and provide demos of solutions during the sales process as needed.
  • RFI/RFP Management: Work with Sales and the proposal team to assist as needed to manage responses and for all RFIs/RFPs related to Risk and Quality, coordinating with internal product experts to develop competitive, compliant responses.
  • Collaboration: Work cross-functionally with Marketing, Product, and Customer Success teams, as well as the Risk Adjustment and Quality teams, to understand key initiatives and their impact; ensure seamless onboarding and long-term client satisfaction; develop professional and positive relationships with customers and colleagues; and maintain a reputation of competence, integrity and professionalism.
  • Market Expansion: Stay informed about industry trends, customer challenges, and emerging opportunities to position HealthEdge as a leader in Risk Adjustment and Quality healthcare SaaS/BPaaS solutions. Monitor CMS regulatory developments, ODAG/HPMS reporting requirements, and risk adjustment coding trends to identify emerging market opportunities and inform sales positioning. Represent within the industry by developing and maintaining comprehensive knowledge of our products, industry trends and general business and financial acumen through various sources and initiatives; communicating in a professional, compelling, and articulate manner of speech, writing and formal presentation.
  • Forecasting & Reporting: Provide accurate information and reporting to both the SVP of Risk Adjustment and Quality, the Sales Team and the CSEs thatofferinsights into pipeline progress and potential risks. Present status and activity updates for all sales pursuits as required.

MINIMUM REQUIRED QUALIFICATIONS

  • 15+ years of experience in Risk Adjustment, Stars, Hedis and Quality Solutions , preferably in healthcare SaaS/BPaaS or enterprise software solutions, with 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, with solid technical knowledge/aptitude with enterprise class insurance transaction and health care 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 assisting sales teams meet or exceed sales targets, with experience in 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, with a focus on delivering innovative solutions to meet client needs.
  • Ability to work independently and travel as needed within the assigned territory.

Geographic Responsibility:  Remote, US

Type of Employment: Full-time, permanent 

Travel%: 33%

FLSA Classification (USA Only): Exempt 

Work Environment: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job:  

  • The employee is occasionally required to move around the office. Specific vision abilities required by this job include close vision, color vision, peripheral vision, depth perception, and ability to adjust focus.  
  • Work across multiple time zones in a hybrid or remote work environment. 
  • Long periods of time sitting and/or standing in front of a computer using video technology. 
  • May require travel dependent on company needs. 

 

The above statements are intended to describe the general nature and level of the job being performed by the individual(s) assigned to this position. They are not intended to be an exhaustive list of all duties, responsibilities, and skills required. HealthEdge reserves the right to modify, add, or remove duties and to assign other duties as necessary. In addition, reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position in compliance with the Americans with Disabilities Act of 1990.  Candidates may be required to go through a pre-employment criminal background check. 

 

#LI-Remote 

**The annual US base salary range for this position is $233,000 to $254,000. This salary range may cover multiple career levels at HealthEdge. Final compensation will be determined during the interview process and is based on a combination of factors including, but not limited to, your skills, experience, qualifications and education.  

About HealthEdge

HealthEdge is a healthcare technology company that provides next-generation core administrative systems, advanced analytics, and engagement tools that enable healthcare organizations to reduce costs, improve outcomes, and enhance the member experience. The company's innovative solutions are built on modern, patented technology and delivered to customers via the HealthRules platform, which is designed to be highly flexible, scalable, and configurable to meet the unique needs of each customer. HealthEdge's customers include health plans, third-party administrators, and self-insured employers.
Learn more about HealthEdge
Size
500 employees
Industry
Founded
2004

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