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.

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.

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

Senior Solutions Consultant – HEDIS, Quality Solutions

Key skills