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Cotiviti logo
Cotiviti

Enabling a high-quality and viable healthcare system

Senior Solutions Consultant – HEDIS, Quality Solutions

Solutions EngineerSolutions EngineerFull TimeRemoteSeniorTeam 5,001-10,000H1B SponsorCompany SiteLinkedIn

Location

United States

Posted

75 days ago

Salary

$140K - $175K / year

Seniority

Senior

Bachelor Degree12 yrs expEnglish

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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