VBC; Value- care​/Quality strategist

The VBC / Quality Strategist is a client-facing expert within Saisystems Health's Customer Success Consulting Practice, specializing in value-based care program strategy, quality measure performance, and clinical quality improvement for provider organization clients. This role helps clients navigate the transition from fee-for-service to value-based reimbursement — improving quality scores, closing care gaps, optimizing risk adjustment, and maximizing performance under ACO, MSSP, PCMH, and payer-specific quality programs.

Partnering with RCM, PacEHR, Payor Enrollment, and Compliance specialists, the VBC / Quality Strategist ensures that clients' quality and value-based initiatives are fully integrated with their revenue cycle and clinical documentation workflows. This is a high-impact advisory role that sits at the intersection of clinical performance, financial incentives, and regulatory compliance.

• Serve as the primary VBC and quality consulting expert for an assigned portfolio of clients, providing advisory support across quality measure performance, care gap closure, risk adjustment, and value-based contract strategy.
• Assess client performance across key quality programs — including HEDIS, STARS, Merit-Based Incentive Payment System (MIPS), alternative payment models (APMs), ACO/MSSP, and payer-
• specific value-based contracts — and deliver improvement roadmaps with clear performance targets.
• Advise clients on care gap identification and closure workflows, integrating quality measure requirements into clinical workflows, EHR documentation, and population health management processes.
• Guide clients in building and executing risk adjustment strategies — including HCC coding accuracy, chronic condition documentation, and Annual Wellness Visit programs — to ensure appropriate risk capture and reimbursement.
• Support clients in PCMH recognition, ACO participation strategy, and quality-based payer contract negotiations, providing expert guidance on program requirements and performance benchmarks.

• Develop and deliver quality performance dashboards and operational reports tailored to client clinical and executive leadership, translating complex measure data into clear priorities and action plans.
• Conduct HEDIS and STARS gap analyses, model performance scenarios, and identify the highest-impact interventions for improving client quality scores.
• Monitor client performance against quality benchmarks, value-based contract targets, and regulatory thresholds — providing proactive alerts and structured recommendations.
• Lead periodic quality performance reviews with client stakeholders, presenting trends, wins, risks, and next-period priorities in an executive-friendly format.

• Lead client-facing advisory sessions, quarterly business reviews, and quality strategy planning meetings with CMOs, quality directors, population health teams, and executive leadership.
• Proactively communicate CMS quality program updates, HEDIS measure changes, payer quality contract amendments, and regulatory developments affecting client performance and reimbursement.
• Build and maintain strong client relationships, serving as a trusted advisor on all quality and VBC matters and escalating issues proactively when performance risks are identified.

• Partner with Account Managers to identify quality and VBC-related expansion opportunities within existing client accounts.
• Collaborate with PacEHR specialists to ensure EHR configurations support quality measure documentation, care gap alerting, and population health workflows.
• Work with RCM specialists on risk…