Vice President, Commercial Pricing & Forecasting

Find out more about this role by reading the information below, then apply to be considered.

Who We Are

Point32Health is a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our communities. At Point32Health, we are building on the quality, nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, where we leverage our experience and expertise to help people find their version of healthier living through a broad range of health plans and tools that make navigating health and wellbeing easier.

We enjoy the important work we do every day in service to our members, partners, colleagues and communities. To learn more about who we are at Point32Health, click here.

Job Summary

The Vice President of Commercial Pricing & Forecasting is responsible for pricing, filing and certifying rates, developing and maintaining rating methodologies, rate factor development, actuarial support for Underwriting, ensuring compliance with new and existing regulatory requirements and assessing our competitiveness in the markets we serve. In addition, responsible for development and maintenance of forecasting models, completion of the financial plan and the ongoing assessment of the financial performance of products and markets, impacting in excess of $4B in revenue. Responsible for prospective pricing and forecasting trends. Supports new product development initiatives, including expansion activities.

Key Responsibilities / Duties – what you will be doing

• Develop actuarially sound rates for all Commercial lines of business and markets
• Support underwriting methodology enhancements and new tool development
• Perform actuarial studies in support of Underwriting, including factor updates, rate structure changes, profitability analysis and segment performance
• Work with market teams on new product development, market positioning and competitive analysis
• Develop, maintain, and enhance forecasting models
• Responsible for forecast and plan development, including revenue, medical expense, pharmacy, pharmacy rebates, capitation, fixed medical, broker commission and other miscellaneous expense items for both the fully and self-insured segments
• Monitor actual to expected results and analyze drivers of variance
• Analyze historical trend and project future pricing trend
• Support regulatory reporting and compliance, e.g. CHIA premium reporting, Mental Health Parity
• Support business expansion efforts into new states and / or products
• Hire, onboard, engage and monitor performance of team members
• Other projects and duties as assigned.

Qualifications – what you need to perform the job

Certification and Licensure

Education

Experience (minimum years required) :

Skill Requirements

Compensation & Total Rewards Overview

As part of our comprehensive total rewards program, colleagues are also eligible for variable pay. Eligibility for any bonus, commission, benefits, or any other form of compensation and benefits remains in the Company's sole discretion and may be modified at the Company’s sole discretion, consistent with the law.

Point32Health offers their Colleagues a competitive and comprehensive total rewards package which currently includes :

Commitment to Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity

Point32Health is committed to making diversity, equity, inclusion, accessibility and health equity part of everything we do—from product design to the workforce driving that innovation. Our Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity team's strategy is deeply connected to our core values and will evolve as the changing nature of work shifts. Programming, events, and an inclusion infrastructure play a role in how we spread cultural awareness, train people leaders on engaging with their teams and provide parameters on how to recruit and retain talented and dynamic talent. We welcome all applicants and qualified individuals, who will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.

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