VP, Sales – Risk & Quality

HealthEdge

. Help sales and CSEs build and maintain relationships with key decision-makers .

Posted 9/24/2026full-timeRemote • United StatesLead💰 $233,000 - $254,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates extensive expertise in Risk Adjustment, STAR Ratings, and HEDIS, with a strong focus on healthcare SaaS solutions. Proven ability to drive sales growth through strategic relationship building and market-specific sales planning.

Highest-signal resume keywords

Risk Adjustment ExpertiseSTAR Ratings KnowledgeHEDIS ExperienceSales Process ManagementHealthcare Industry Knowledge

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Risk AdjustmentSTAR RatingsHEDISQuality Improvement SolutionsSales Target AchievementMarket-Specific Sales PlanningClient Workflow AnalysisCRM ManagementMedicare Advantage StrategiesManaged Medicaid Risk Adjustment

Soft Skills

Excellent Communication SkillsInterpersonal SkillsAnalytical AbilitiesProblem-Solving SkillsPresentation Skills

Tools & Technologies

HealthEdge Product SuiteHealthcare Management Information SystemsCRM Software

Industry Keywords

Healthcare SaaSBPaaSValue-Based CarePayer/Provider DynamicsCMS Regulatory Requirements

About the role

Key responsibilities & impact

Help sales and CSEs build and maintain relationships with key decision-makers
Understand client needs and align current and future solutions with strategic goals
Assist in developing and executing market-specific sales plans using market insights and competitive intelligence
Work with Sales and Marketing to design and implement strategic direction for top prospects
Partner with Sales Operations, Product, Technology, Marketing, and Client Services to identify, scope, and determine key prospects
Drive new business and expand existing accounts to increase annual recurring revenue
Sell Risk Adjustment and Quality solutions, including retrospective and prospective Risk Adjustment offerings, STAR ratings, HEDIS, and quality improvement solutions
Execute the sales process by analyzing client workflows, matching needs to solutions, conducting presentations and demonstrations, negotiating pricing and contracts, closing sales, and updating the CRM
Help identify, qualify, and pursue new business opportunities and maintain a healthy sales pipeline
Engage management and executive-level prospects, build relationships, network with associations, and provide solution demonstrations
Assist with RFI/RFP responses and coordinate with internal product experts
Collaborate cross-functionally to support onboarding and long-term client satisfaction
Monitor industry trends, customer challenges, CMS regulatory developments, ODAG/HPMS reporting requirements, and risk adjustment coding trends
Provide pipeline forecasts, status updates, activity reports, and risk insights to sales leadership and teams

Requirements

What you’ll need

15+ years of experience in Risk Adjustment, Stars, HEDIS, and Quality Solutions, preferably in healthcare SaaS/BPaaS or enterprise software solutions
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 and solid technical knowledge/aptitude with enterprise-class insurance transaction and healthcare 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 sales targets, with experience 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
Ability to work independently and travel as needed within the assigned territory
Ability to work across multiple time zones in a hybrid or remote work environment
Candidates may be required to undergo a pre-employment criminal background check

Benefits

Comp & perks

Equal opportunity employer committed to workforce diversity
Reasonable accommodations for individuals with disabilities
Remote or hybrid work environment
Travel as needed within the assigned territory
Pre-employment criminal background check