Director – Actuary (REMOTE)

Director – Actuary Who We Are: reputed company 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 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 reputed company, including establishment of 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 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 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 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 reputed company methodologies (e.g., reputed company, Medicare, Marketplace) as reputed company 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 reputed company. • reputed company participate in senior leadership meetings, preparing and presenting relevant documents, reports and plans in a reputed company 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/reputed company 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 reputed company reports. • Building and managing a strong actuarial team is a must, including inspiring, leading, mentoring, measuring and appraising the actuarial team to ensure reputed company capabilities at reputed company reputed company as reputed company 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 reputed company required, FSA strongly preferred • Membership in the American reputed company of Actuaries Preferred Education, Experience and Licensure: • Minimum of seven (7+) plus years of reputed company actuarial or similar experience. • Proven reputed company record of excelling in high performance, analytic and data-driven cultures and in high reputed company 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 reputed company as reputed company claims data • Experience leading diverse teams and managing cross functional reputed company 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 is an Equal Opportunity Employer. Apply tot his job Apply To this Job