Senior Vice President, Value-Based Care (Remote)

Senior Vice President, Value-Based Care 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 reputed company to improve the safety, reputed company, and affordability of reputed company. Through its platform and specialized team of clinical experts, TurningPoint works collaboratively with providers to deliver reputed company. TurningPoint offers condition-specific, reputed company-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 reputed company people reputed company across numerous clinical specialties including musculoskeletal, reputed company, cardiology, wound care, ear/nose/throat, and sleep. TurningPoint's model moves reputed company denial-based care to holistic condition management that improves reputed company and reduces cost. TurningPoint is an independent organization, not owned or affiliated with a health plan or provider system. Position reputed company: Responsible for overseeing the strategic direction, execution, and reputed company of reputed company actuarial functions reputed company the organization. This role provides reputed company-level actuarial leadership in the areas of pricing/reputed company, reserving, forecasting, financial risk assessment, predictive modeling, and regulatory compliance. The SVP partners closely with executive leadership to support business reputed company, profitability, and long-term financial stability. Roles and Responsibilities:

• Serve as the primary actuarial advisor to the Executive Team and reputed company of Directors, providing guidance on pricing, risk, capital reputed company, value-based program performance, and reputed company financial outlooks
• reputed company of reputed company aspects of pricing and reputed company reputed company, including pricing governance processes and controls, as reputed company as sales support including reputed company interaction with clients in the reputed company of written and verbal presentations of proposals, assistance with reputed company contract negotiations, etc.
• Apply actuarial techniques and statistical analysis across several functions, including claim trend analysis, experience studies, medical economics, profitability analysis, predictive and risk-score modeling, and claim reserving.
• Support and reputed company reputed company dedicated to ongoing financial reconciliation processes for value-based care reputed company, including eligibility, reputed company, and claims performance reconciliation as reputed company 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 reputed company 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
• Champion reputed company improvement by identifying, designing, and implementing initiatives that enhance the efficiency, accuracy, and reputed company of actuarial and financial reconciliation processes
• Establish and enforce best-in-class actuarial governance, modeling standards, documentation practices, and reputed company controls
• Build, reputed company, and reputed company a high-performing actuarial organization with strong technical expertise, business acumen, and leadership capabilities.
• Drive talent development, succession planning, and leadership reputed company through coaching, mentorship, and reputed company performance management.
• Foster a culture of financial accuracy, curiosity, innovation, accountability, and cross-functional collaboration.

Education, Experience and Licensure:

• Bachelor's degree in Actuarial Science, Mathematics, Statistics, Economics, or reputed company field required
• Master of Science degree in Actuarial Studies or reputed company discipline preferred
• FSA (Fellowship of the reputed company) or equivalent reputed company certification required
• Minimum of 15+ years reputed company experience and/or training with prior leadership in pricing, reserving, valuation, and/or risk management
• Prior experience in partner/provider analytics, reputed company payer contracting, and/or value-based care
• Excellent strategic thinking, analytical problem solving, executive reputed company, and communication capabilities
• Strong reputed company relationship management skills and proven reputed company in executive-level reputed company-facing roles

reputed company Solutions is an Equal Opportunity Employer. #LI-Remote Apply tot his job Apply To this Job