Associate Actuary

TURNINGPOINT HEALTHCARE SOLUTIONS LLC; United States; On-site; USD 120,000 - 190,000; Full time

Job summary

TurningPoint Healthcare Solutions is seeking an Associate Actuary to lead actuarial studies, underwriting and pricing models for value-based contracts and client engagements.

This role requires strong analytical ability, leadership experience, and the ability to communicate complex technical concepts to non-technical stakeholders. Proficiency in SQL, SAS or Python and a healthcare actuarial background are highly valued.

Qualifications

• Bachelor’s degree in a relevant quantitative field is required.
• ASA designation is required; FSA is preferred.
• 5+ years healthcare actuarial experience with analytic focus.

Responsibilities

• Develop pricing and underwriting models for contracts and proposals.
• Apply actuarial methods to claim trends, experience studies and profitability.
• Support reconciliation and financial reporting for value-based care.
• Lead complex studies and present findings to senior management.
• Design risk adjustment models and translate outputs to pricing strategies.
• Mentor staff and drive cross-functional initiatives.

Skills

Actuarial analysis

Pricing models

SQL

SAS

Python

Education

Bachelor’s degree in mathematics, Statistics, Actuarial Science, Finance, Economics or related field

ASA in the Society of Actuaries

Membership in the American Academy of Actuaries

5+ years healthcare actuarial experience

Tools

SQL

SAS

Python

Job description

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

This opportunity requires a highly analytical financial professional with consistent results in adding value through actuarial and analytical analysis. The Associate 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.

Requirements

• Develop comprehensive pricing and underwriting models, 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 analyses across several functions, including claim trend analyses, experience studies, medical economics, profitability analysis, risk adjustment, 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
• 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 continuous performance monitoring, and translate outputs into actionable insights for pricing and value-based care strategy.
• Actively participate in 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.
• Development of staff and succession planning. Communicates goals, objectives, accountabilities, priorities, and authority parameters to assigned staff. Develop leaders through mentoring and coaching of direct reports.

Education, Experience and Licensure

• 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 of seven (5+) 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
• Excellent communication skills required for client-facing conversations and presentations
• Proficiency in SQL, SAS, or an understanding of Python strongly preferred

TurningPoint Healthcare Solutions is an Equal Opportunity Employer.