Senior Payer Strategy & Risk-Quality Executive

Veradigm Inc.; Northern (KY); Hybrid; USD 163,000 - 216,000; Full time

Job summary

Veradigm Inc. in the United States seeks an Outcome Executive to oversee strategic relationships with enterprise payer accounts, including health plans, MCOs, and other risk-bearing entities.

You will own C-suite engagement, annual account planning, QBR cadence, and revenue outcomes, while driving risk adjustment, Stars/HEDIS programs, and payer-provider data exchange. This senior role requires autonomous leadership and collaboration with Sales, Consulting, Support, and A/R to expand Veradigm’s

Responsibilities

• Serve as primary strategic partner to C-suite and senior leadership within assigned portfolio of enterprise payer accounts — owning the full client relationship across quality, risk, network, and regulatory touchpoints
• Build and maintain executive-level relationships through on-site visits, QBRs, and proactive engagement
• Understand and document each plan’s enterprise priorities — Stars and HEDIS targets, risk adjustment accuracy, medical loss ratio pressure, value-based care strategy, and interoperability mandates
• Analyze plan membership, line-of-business mix, and product utilization data to identify whitespace and translate findings into actionable pipeline and sales strategy
• Position Veradigm risk adjustment and quality solutions against each plan’s annual program cycle and align proposal timing to that cycle
• Position payer-provider clinical data exchange solutions to meet plan requirements for data exchange, interoperability, and prior authorization workflows
• Drive ACV quota attainment and MBO performance through pipeline management and forecasting
• Navigate payer procurement, security review, and contracting processes with Legal, InfoSec, and Privacy
• Advocate internally for client needs and represent the payer voice in roadmap discussions
• Partner with Consulting, Support, and A/R to ensure delivery and early resolution of at-risk situations
• Maintain knowledge of CMS and NCQA program mechanics to credibly advise executive stakeholders
• Conduct whitespace and competitive analysis to expand Veradigm’s footprint across plans

Job description

Veradigm Inc. in the United States seeks an Outcome Executive to oversee strategic relationships with enterprise payer accounts, including health plans, MCOs, and other risk-bearing entities.

You will own C-suite engagement, annual account planning, QBR cadence, and revenue outcomes, while driving risk adjustment, Stars/HEDIS programs, and payer-provider data exchange. This senior role requires autonomous leadership and collaboration with Sales, Consulting, Support, and A/R to expand Veradigm’s