Outcomes Executive

🔥 0 minutes ago

🌲 North Carolina – Remote

🌲 North Carolina – Remote

💵 $163k - $216.3k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Executive

👻 Ghost score 1%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Veradigm®

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

☁️ SaaS

⚕️ Healthcare Insurance

💰 $75M Post-IPO Debt - Veradigm on 2025-06

Healthcare • SaaS • Healthcare Insurance

Veradigm is a healthcare technology company that provides cloud-based clinical, financial and data solutions for providers, payers and life-sciences organizations. Its offerings include electronic health records, practice management, revenue cycle services, e-prescribing, data exchange and APIs, real-world data and evidence platforms, analytics for quality and risk adjustment, and patient engagement tools — all delivered via a connected Veradigm Network to support care delivery, payer operations and research.

📋 Description

• Serve as the primary strategic partner to C-suite and senior functional leadership within an assigned portfolio of enterprise payer accounts • Own the full client relationship across quality, risk, network, and regulatory touchpoints • Build and maintain executive-level relationships through on-site visits, quarterly business reviews, and proactive engagement • Document each plan’s enterprise priorities 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 and translate findings into pipeline and sales strategy • Position Veradigm risk adjustment and quality solutions around each plan’s annual program cycle • Position payer-provider clinical data exchange solutions using Veradigm’s provider network and data assets • Drive ACV quota attainment and MBO performance through pipeline management, forecasting, and opportunity progression • Navigate payer procurement, security review, and contracting processes to move enterprise agreements and data use terms to signature • Advocate internally for client needs, 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 resolve at-risk situations before they affect retention • Conduct whitespace and competitive analysis to expand Veradigm’s footprint and identify new use cases

🎯 Requirements

• Significant experience managing strategic relationships with enterprise payer accounts • Deep knowledge of risk adjustment and quality programs, including HEDIS and Medicare Advantage Stars • Knowledge of payer-provider clinical data exchange • Knowledge of payer medical economics, quality and risk performance, and regulatory obligations • Experience with C-suite and senior functional leadership engagement • Experience with annual account planning and QBR cadence • Ability to analyze plan membership, line-of-business mix, and product utilization data • Knowledge of Medicare Advantage, Medicaid, commercial, and ACA lines of business • Knowledge of chart retrieval and review, supplemental data submission, gap identification and closure, and audit readiness • Understanding of clinical data acquisition, interoperability compliance, and prior authorization workflow • Ability to drive ACV quota attainment and MBO performance through pipeline management, forecasting, and opportunity progression • Experience navigating payer procurement, security review, contracting, Legal, InfoSec, and Privacy processes • Working knowledge of CMS and NCQA program mechanics, risk adjustment models and submission, RADV audit exposure, HEDIS measure specifications, Medicare Advantage Stars, and federal interoperability and prior authorization rules • Must be legally authorized to work in the United States or Canada • Visa sponsorship is not offered

🏖️ Benefits

• Holidays • Vacation • Medical insurance • Dental insurance • Vision insurance • Company-paid life insurance • Retirement savings • Professional development opportunities • Flexible work arrangements/tools to bring the best version of themselves to work