This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a VP, Sales (Risk & Quality) based in the United States.
The VP, Sales (Risk & Quality) will play a senior commercial leadership role focused on expanding revenue and strengthening client relationships across healthcare risk adjustment and quality solutions. This position supports new business development, strategic account growth, and market expansion across Medicare Advantage, ACA, and Managed Medicaid markets. You will work closely with senior health plan stakeholders to understand business priorities and align them with SaaS and BPaaS solutions. The role combines complex enterprise sales, healthcare industry expertise, pipeline development, and strategic client engagement. You will partner across Sales, Marketing, Product, Technology, Client Services, and Risk Adjustment and Quality teams to advance opportunities and support long-term customer value. The position is remote within the United States and requires approximately 33% travel.
Accountabilities:
- Drive new revenue opportunities and support expansion within existing client accounts across risk adjustment and quality solutions, with a focus on retrospective and prospective risk adjustment offerings delivered through SaaS and BPaaS models.
- Build and maintain relationships with senior decision-makers at health plans, understanding their strategic priorities, operational challenges, technology environments, and business objectives to align appropriate solutions.
- Develop and execute market-specific sales strategies using industry intelligence, competitive insights, customer needs, and market growth opportunities to support revenue objectives and sales targets.
- Identify, qualify, and advance strategic prospects by working with Sales, Client Services, Marketing, Sales Operations, Product, Technology, and other internal stakeholders to assess opportunities, develop positioning, and coordinate pursuit strategies.
- Manage complex sales processes from initial discovery through presentations, demonstrations, workflow analysis, solution alignment, commercial negotiations, contracting, and CRM documentation.
- Support healthy pipeline development by identifying target organizations, cultivating executive-level relationships, networking within relevant healthcare associations, and creating introductions to additional decision-makers and operational stakeholders.
- Support RFI and RFP responses related to Risk and Quality, coordinating with internal subject-matter experts to develop accurate, competitive, and compliant proposals.
- Collaborate cross-functionally to support successful client onboarding, ongoing customer satisfaction, product evolution, and long-term account relationships.
- Monitor healthcare industry trends, customer challenges, competitive developments, and emerging market opportunities to strengthen sales positioning and identify areas for expansion.
- Track and interpret CMS regulatory developments, including relevant STAR, HEDIS, ODAG, and HPMS requirements, as well as changes in risk adjustment coding and quality programs that may influence customer needs.
- Provide accurate pipeline forecasts, sales activity reporting, opportunity updates, and risk assessments to senior sales leadership and relevant client-facing teams.
- Represent the organization professionally within the healthcare technology and payer ecosystem through industry engagement, customer meetings, presentations, networking, and thought leadership.
Requirements:
- 15+ years of experience in Risk Adjustment, Stars, HEDIS, Quality Solutions, healthcare SaaS/BPaaS, or enterprise healthcare technology, with substantial knowledge of Medicare Advantage, ACA, and/or Managed Medicaid risk adjustment strategies.
- Demonstrated experience with retrospective and prospective risk adjustment programs, quality improvement solutions, CMS requirements, STAR ratings, and HEDIS.
- Strong healthcare subject-matter expertise, including an understanding of payer and provider dynamics, risk adjustment, quality programs, and value-based care.
- Experience with BPaaS and SaaS delivery models in risk adjustment outsourcing or related healthcare services, including the ability to discuss build-versus-buy considerations with health plan stakeholders.
- Proven track record supporting or leading complex, multi-stakeholder enterprise sales processes and achieving or contributing to sales revenue targets.
- Strong technical aptitude and understanding of enterprise healthcare transaction systems, health plan technologies, and healthcare management information systems.
- Excellent presentation, communication, and interpersonal skills, with the ability to translate complex healthcare and technical concepts into clear business value for executive and non-technical audiences.
- Strong analytical, consultative, and problem-solving capabilities, with a focus on developing solutions aligned with customer requirements and strategic objectives.
- Ability to work independently, manage multiple strategic opportunities, and collaborate effectively across geographically distributed and cross-functional teams.
- Willingness and ability to travel approximately 33% within the assigned territory and as required for customer and business needs.
- Remote work capability, including comfort working across multiple time zones and spending extended periods using computer and video-conferencing technology.
Benefits:
- Annual US base salary range of $233,000–$254,000, with final compensation determined based on factors such as skills, experience, qualifications, and education.
- Full-time, permanent employment.
- Remote position within the United States.
- Approximately 33% travel, providing opportunities for direct engagement with customers, prospects, and industry stakeholders.
- Opportunity to work at the intersection of healthcare technology, risk adjustment, quality improvement, SaaS/BPaaS, and enterprise sales.
- Exposure to senior healthcare executives and complex strategic sales opportunities across Medicare Advantage, ACA, and Managed Medicaid markets.
- Opportunity to contribute to product positioning, market expansion, client strategy, and the evolution of healthcare technology solutions.
- Flexible remote work environment supporting collaboration across multiple time zones.
How Jobgether works:
We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.
We appreciate your interest and wish you the best!
Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.
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