Veradigm Outcomes 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

This position is responsible for the full strategic relationship across a portfolio of enterprise payer accounts — health plans, managed care organizations, and other risk-bearing entities — for the Veradigm Payer Products portfolio. The Veradigm Outcome Executive (VOE) is the most senior client-facing individual contributor for these accounts, with particular focus on risk adjustment and quality programs (HEDIS and Stars) and on payer-provider clinical data exchange. Serving as the integration layer across Sales, Consulting, Support, and A/R, the VOE drives retention, expansion, and wallet share through deep knowledge of each plan’s medical economics, quality and risk performance, and regulatory obligations. The role operates with significant autonomy and is fully accountable for C-suite engagement, annual account planning, QBR cadence, and measurable revenue outcomes. **CORE RESPONSIBILITIES*** Serve as the primary strategic partner to C-suite and senior functional leadership within an assigned portfolio of enterprise payer accounts — including Chief Medical Officer, Chief Actuary, quality and Stars leadership, risk adjustment leadership, and Chief Information Officer — owning the full client relationship across quality, risk, network, and regulatory touchpoints* Build and maintain executive-level relationships through on-site visits, quarterly business reviews (QBRs), and proactive engagement, establishing Veradigm as a trusted long-term partner* 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 — and develop and execute annual account plans focused on retention, optimization, and expansion* Analyze plan membership, line-of-business mix, and product utilization data to identify whitespace across Medicare Advantage, Medicaid, commercial, and ACA lines of business; translate findings into actionable pipeline and sales strategy* Position Veradigm risk adjustment and quality solutions against each plan’s annual program cycle — chart retrieval and review, supplemental data submission, gap identification and closure, and audit readiness — and align proposal timing to that cycle* Position payer-provider clinical data exchange solutions, connecting plan requirements for clinical data acquisition, interoperability compliance, and prior authorization workflow to Veradigm’s provider network and data assets* Drive ACV quota attainment and MBO performance through disciplined pipeline management, accurate forecasting, and timely opportunity progression* Navigate payer procurement, security review, and contracting processes, coordinating Legal, InfoSec, and Privacy to move enterprise agreements and data use terms to signature* Advocate internally for client needs — surface product feedback, coordinate cross-functional issue resolution, and represent the payer voice in roadmap and strategy discussions* Partner with Consulting, Support, and A/R to ensure dependable delivery and early resolution of at-risk situations before they affect retention* Maintain deep working knowledge of CMS and NCQA program mechanics — risk adjustment models and submission, RADV audit exposure, HEDIS measure specifications, the Medicare Advantage Stars program, and federal interoperability and prior authorization rules — to credibly advise executive stakeholders* Conduct whitespace and competitive analysis to expand Veradigm’s footprint within each plan and identify new use cases across additional lines of business**Compensation Range:**$163,000-$216,300