| Senior Vice President, Value-Based Care Who We Are: TurningPoint Healthcare Solutions is a leader in advanced clinical and technology-enabled complex condition management. TurningPoint provides an innovative suite of specialty care management services and technologies that enable 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 optimal care. 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 nationwide 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: Responsible for overseeing the strategic direction, execution, and quality of all actuarial functions within the organization. This role provides enterprise-level actuarial leadership in the areas of pricing/underwriting, reserving, forecasting, financial risk assessment, predictive modeling, and regulatory compliance. The SVP partners closely with executive leadership to support business growth, profitability, and long-term financial stability. Roles and Responsibilities: - Serve as the primary actuarial advisor to the Executive Team and Board of Directors, providing guidance on pricing, risk, capital strategy, value-based program performance, and enterprise financial outlooks
- Oversight of all aspects of pricing and underwriting strategy, including 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 client 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 lead a team dedicated to ongoing financial reconciliation processes for value-based care contracts, including eligibility, revenue, and claims performance 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 internal and external 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
- Champion continuous improvement by identifying, designing, and implementing initiatives that enhance the efficiency, accuracy, and impact of actuarial and financial reconciliation processes
- Establish and enforce best-in-class actuarial governance, modeling standards, documentation practices, and quality controls
- Build, lead, and inspire a high-performing actuarial organization with strong technical expertise, business acumen, and leadership capabilities.
- Drive talent development, succession planning, and leadership growth through coaching, mentorship, and structured 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 related field required
- Master of Science degree in Actuarial Studies or related discipline preferred
- FSA (Fellowship of the Society of Actuaries) or equivalent professional certification required
- Minimum of 15+ years related experience and/or training with prior leadership in pricing, reserving, valuation, and/or risk management
- Prior experience in partner/provider analytics, healthcare payer contracting, and/or value-based care
- Excellent strategic thinking, analytical problem solving, executive presence, and communication capabilities
- Strong client relationship management skills and proven success in executive-level client-facing roles
TurningPoint Healthcare Solutions is an Equal Opportunity Employer.
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