The SSI Group, LLC, headquartered in Mobile, Alabama, is a national leader in Healthcare Technology.

Purpose of position: An Experienced Data Transport and Quality Measures sales executive working in a leading Payor/Provider software and service vendor with relevant healthcare payment accuracy, payment integrity, FWA, Quality, Performance Analytics, and/or Risk Adjustment is also key. Deep industry/sales knowledge of all lines of business (Medicare, Medicaid, Commercial) for healthcare payment, quality, and risk solutions such as claim editing, clinical chart review, coordination of benefits, data mining and/or fraud, waste, and abuse market, HEDIS, Medicare and Commercial Risk Adjustment is highly desirable. The position will work remotely within the U.S.

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Target Market: Servicing larger hospital and provider groups on disparate systems that need a central way to collect clinical data, as well as reporting quality measures including: (need to define further)

• Integrated delivery systems (IDNs),
• Health information exchanges (HIEs),
• Academic Medical Center
• Independent Practice Associations (IPAs)
• Regional Health Information Systems (RHIOs).
• Individual hospitals,

Essential Functions: (must be able to perform these functions, with or without reasonable accommodation).

• Understanding various payment systems across Medicare, Medicaid, and commercial insurance. This involves knowing how claims should be processed, identifying billing inaccuracies, and ensuring payment integrity.
• Knowledgeable of strategies to prevent fraud, waste, and abuse within healthcare transactions to mitigate these risks.
• The utilization of analytics to measure and improve healthcare outcomes. Possibly working with HEDIS measures or similar quality reporting standards to evaluate healthcare provider performance.

• Understanding risk adjustment mechanisms, especially in Medicare and commercial settings, to ensure accurate representation of patient populations and fair compensation for caregivers and providers.
• Familiarity with national networks connecting healthcare organizations such as eHealth Exchange, The Sequoia Project, CommonWell Health Alliance, and Carequality.
• High-level understanding of integration and interoperability concepts that support the networks necessary for exchanging clinical data, e.g. HL7, IHE, and FHIR.
• Understanding of national initiatives driven by the Office of the National Coordinator for Health Information Technology (ONC), i.e., TEFCA.
• Knowledge of software solutions that support these functions, including claim editing tools, clinical chart review platforms, and coordination of benefits systems.
• Maintains up-to-date knowledge of industry competitors and consultants.
• Generates leads within territory - New Business
• Secures introductory meetings with C-level audiences, including CEO, CIO, CMO, CMIO, etc.
• Completes assessment of prospects to highlight critical needs.
• Coordinates product and company overview demonstrations by defining key product needs aligned with specific client opportunities.
• Prepares/presents pricing - Coordinates RFP responses.
• Manage assigned territory to achieve defined sales quota.
• Work with the Technology Team to clearly define the technical compatibility of partnership solutions and the impact of "joint" solutions in the market.

Other Responsibilities as needed:

• Focus on client retention (Renewals) and expanding the SSI footprint within these sites.
• Prepare action plans and schedules to identify specific targets and to project the number of contacts to be made
• Follow-up on leads and referrals resulting from Marketing promotion and field activity
• Establish and maintain current customer relationships
• Tradeshow support and attendance
• Prepare paperwork to activate and maintain contract services
• Communicate new product and service opportunities, special developments, information, or feedback gathered through field activity to appropriate company staff

Skills, Knowledge, and Abilities:

SSI offers competitive salaries and an excellent benefits package including medical, dental, life/AD&D, LTD, vision, 401(k) matching, paid vacation and tuition reimbursement.

• The SSI Group, Inc., 4721 Morrison Drive, Mobile, Alabama, United States of America
• Virtual