Director, Actuary

Who We Are:

TurningPoint Healthcare Solutions is disrupting the traditional approach to specialty care management through innovative technology and world-class clinical expertise.

Founded in 2014, TurningPoint has built a team of 400 leading healthcare experts, clinicians, and technologists helping customers across 35 states manage the health and wellness of 42M patient lives and $4B in medical expenditures each year. TurningPoint empowers health plans and providers to improve the quality, safety, and affordability of healthcare.

TurningPoint specializes in treating the most complex areas of care management including musculoskeletal, pain management, cardiology, wound care, oncology, ear/nose/throat, sleep, and implantable devices. Leveraging data analytics, AI, and machine learning as well as the latest advancements in telemedicine solutions, TurningPoint brings patients, providers, and health plans together to manage risk, lower costs, and drive better outcomes.

Position Summary:

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, underwriting and pricing models, and predictive analyses for the business.

Roles and Responsibilities:

• Develop a comprehensive pricing and underwriting 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, predictive modeling, and/or claim reserving.
• Support ongoing financial reconciliation processes for value-based care contracts, including eligibility, revenue, and claims reconciliation as well as ad hoc financial operations reporting, provider network analysis, and fee schedule pricing
• Independently initiate and lead the development of complex actuarial studies, analyses, and presentation materials needed to appropriately inform decision makers. Make appropriate recommendations to senior management across teams both within the finance department and across other departments to optimize value-based contract performance
• 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 within areas of oversight. 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 all levels as well as driving a culture of financial accuracy and accountability

Minimum Education, Licensure and Professional Certification requirement:

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

Minimum Experience:

• Minimum of seven (7 ) 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 complex assignments and ability to visualize, articulate, and solve complex problems while leading others to complete complex assignments
• Ability to present highly technical concepts to technical and non-technical audiences
• Proficiency in SQL, SAS, or an understanding of Python strongly preferred

TurningPoint Healthcare Solutions is an Equal Opportunity Employer.