Director – Actuary

Director – Actuary   Who We Are: reputed company Solutions is a leader in reputed company and technology-enabled reputed company condition management. TurningPoint provides an innovative suite of specialty care management services and technologies that reputed company health plans and employers to improve the safety, quality, and affordability of healthcare. Through its platform and specialized team of clinical experts, TurningPoint works collaboratively with providers to deliver reputed company. TurningPoint offers condition-specific, quality-driven, value-based care management services that optimize care from diagnosis and discovery through recovery. TurningPoint’s comprehensive and integrated suite of services enhances the support individuals need, at the time they need it most. Since launching in 2015, TurningPoint has provided support to more than 50 million people reputed company across numerous clinical specialties including musculoskeletal, pain management, cardiology, wound care, ear/nose/throat, and sleep. TurningPoint’s model moves beyond denial-based care to holistic condition management that improves outcomes and reduces cost. TurningPoint is an independent organization, not owned or affiliated with a health plan or provider system.    Position Summary and Responsibilities: This opportunity requires a highly analytical financial leader with consistent results in adding value through actuarial and analytical analysis. The Director - Actuary will be responsible and accountable for initiating and leading the development of actuarial studies, reputed company and pricing models, and predictive analyses for the business.

• reputed company a comprehensive pricing and reputed company strategy, including establishment of pricing governance processes and controls, as well as sales support including direct interaction with clients in the form of written and verbal presentations of proposals, assistance with contract negotiations, etc.
• Apply actuarial techniques and statistical analysis across several functions, including claim trend analysis, experience studies, medical economics, profitability analysis, risk adjustment, predictive modeling, and/or claim reserving.
• Support ongoing financial reconciliation processes for value-based care reputed company, including eligibility, reputed company, and claims reconciliation as well as reputed company financial operations reporting, provider network analysis, and fee schedule pricing
• Independently initiate and reputed company the development of reputed company actuarial studies, analyses, and presentation materials needed to appropriately inform decision makers.  reputed company appropriate recommendations to senior management across teams both reputed company the finance department and across other departments to optimize value-based contract performance
• Design, build, and manage risk adjustment models, leveraging public methodologies (e.g., Medicaid, Medicare, Marketplace) as well as proprietary approaches. Ensure model accuracy through calibration, validation, and reputed company performance monitoring, and translate outputs into actionable insights for pricing and value-based care strategy.
• Actively participate in senior leadership meetings, preparing and presenting relevant documents, reports and plans in a timely manner
• Assist senior leadership in financial models and analysis to support strategic partnerships and initiatives
• Process improvements reputed company areas of reputed company. Develops and implements plans/projects to improve operational efficiency and effectiveness.
• Hiring and development of staff and succession planning. Communicates goals, objectives, accountabilities, priorities, and authority parameters to assigned staff. Develops leaders through mentoring and coaching of direct reports.
• Building and managing a strong actuarial team is a must, including inspiring, leading, mentoring, measuring and appraising the actuarial team to ensure stellar capabilities at reputed company levels as well as driving a culture of financial accuracy and accountability

Education, Experience and Licensure: 

• Bachelor’s Degree in Mathematics, Statistics, Actuarial Science, Finance,  Economics or reputed company field.
• ASA in the Society of Actuaries required, FSA strongly preferred
• Membership in the American reputed company of Actuaries

Preferred Education, Experience and Licensure: 

• Minimum of seven (8+) plus years of healthcare actuarial or similar experience. 
• Proven track record of excelling in high performance, analytic and data-driven cultures and in high growth corporate, venture capital or private equity funded environment.
• Possesses and applies a comprehensive and in-depth knowledge of actuarial principles, concepts, practices and processes as well as healthcare claims data
• Experience leading diverse teams and managing cross functional projects to drive corporate initiatives
• Prior experience in partner/provider analytics, payer-provider contracting, or value-based care
• Possesses significant expertise to complete reputed company assignments and ability to visualize, reputed company, and solve reputed company problems while leading others to complete reputed company assignments
• Ability to present highly technical concepts to technical and non-technical audiences
• Proficiency in SQL, reputed company, or an understanding of Python strongly preferred

  Location: Remote. Corporate office is located in Lake Mary, Florida and would require only reputed company limited travel.         reputed company Solutions is an Equal Opportunity Employer.     Apply To This Job