Vice President, Sales (Risk & Quality) (Remote)

HealthEdge: Healthcare SaaS To Accelerate Digital Transformation; United States; Remote; USD 233,000 - 254,000; Full time

Job summary

HealthEdge is seeking a VP of Sales for Risk & Quality to drive recurring revenue in a remote US capacity. You will guide sales, partner with product and marketing, and manage strategic client relationships across Medicare Advantage, ACA, and Managed Medicaid markets.

The role demands leadership, deep risk-adjustment knowledge, and a track record of exceeding targets. Reporting to the SVP, Sales, RAQ, you will shape market strategy, collaborate across departments, and foster long-term client

Qualifications

• 15+ years in Risk Adjustment, Stars, Hedis and Quality Solutions, healthcare SaaS/BPaaS or enterprise software.
• Experience selling quality-improvement solutions tied to CMS requirements, including STAR ratings and HEDIS.
• Healthcare SME with knowledge of enterprise insurance systems; BPM/CRM experience preferred.

Responsibilities

• Build and maintain relationships with key decision-makers.
• Develop and execute market-specific sales plans with leadership and product teams.
• Drive new business and expand existing accounts in Risk Adjustment and Quality.
• Collaborate with Marketing, Product, and Customer Success to align initiatives.
• Stay informed on CMS developments and market opportunities; identify risks and opportunities.
• Forecast and report to SVP of Risk Adjustment and Quality and Sales leadership.

Skills

Risk Adjustment

HEDIS

CMS requirements

Healthcare SaaS

Sales leadership

Enterprise software

Communication skills

Travel willingness

Job description

VP, Sales (Risk & Quality)

Location: Remote, UNAVAILABLE, US

Employment Type: FULL_TIME

Overview

HealthEdge® offers AI-powered operational infrastructure for health insurance companies, guaranteeing an enduring financial edge in an increasingly competitive market. We're experiencing strong market momentum, with a growing number of health plans choosing HealthEdge to modernize their operations and compete more effectively. As we expand, we're investing in the people who power that growth, making this a pivotal moment to join us and shape the future of healthcare technology. Learn more at HealthEdge.com.

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, and 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.

HealthEdge is an equal opportunity employer. We are committed to workforce diversity and actively encourage all qualified persons to seek employment with us, including, but not limited to, racial and ethnic minorities, women, veterans and persons with disabilities.

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**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 bedeterminedduring the interview process and is based on a combination of factors including, but not limited to, your skills, experience,qualificationsand education.