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Enabling a high-quality and viable healthcare system
Senior Solutions Consultant – HEDIS, Quality Solutions
Location
United States
Posted
75 days ago
Salary
$140K - $175K / year
Seniority
Senior
Job Description
Senior Solutions Consultant – HEDIS, Quality Solutions
Cotiviti
• Partner with Sales on strategic opportunities involving quality measurement and Star Ratings solutions. • Lead product demonstrations showcasing HEDIS performance analytics, care gap identification, and quality improvement capabilities. • Present to health plan quality directors, Star Ratings teams, and executive leadership. • Conduct discovery sessions to understand customer quality challenges, current performance, and improvement goals. • Support pilot and proof-of-concept initiatives to demonstrate solution value. • Develop technical content for quality and HEDIS-focused RFP responses. • Articulate how Cotiviti's solutions address NCQA HEDIS certification requirements. • Present solutions during finalist presentations with focus on quality improvement outcomes. • Support implementation scoping and level-of-effort estimates for complex engagements. • Capture customer feedback on product capabilities, gaps, and enhancement priorities. • Maintain deep expertise in NCQA HEDIS measures, specifications, and reporting requirements. • Develop and deliver training for Sales teams on quality measurement fundamentals.
Job Requirements
- Bachelor's degree in Healthcare Administration, Public Health, Nursing, or related field.
- 12+ years of experience in healthcare quality measurement, HEDIS operations, or Star Ratings improvement.
- Deep knowledge of NCQA HEDIS measures, specifications, and certification requirements.
- Understanding of CMS Medicare Star Ratings methodology and Part C/D measures.
- Experience in pre-sales, consulting, or customer-facing roles in healthcare technology.
- Strong presentation skills with ability to engage executive and technical audiences.
- Excellent written communication for RFP responses and technical documentation.
Benefits
- Health insurance
- Dental insurance
- Vision insurance
- Disability insurance
- Life insurance coverage
- 401(k) savings plans
- Paid family leave
- 9 paid holidays per year
- 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service
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