Vice President, Affordability

Point32Health • Canton, MA

2d • $285,000 - $350,000

About The Position

Point32Health is seeking a seasoned enterprise affordability leader to drive and accelerate our organization-wide affordability strategy across Commercial, Individual & Small Group, Medicare, Duals, and Medicaid lines of business throughout New England. This executive will lead enterprise efforts to reduce Total Cost of Care (TCOC), improve medical cost performance, and strengthen long-term affordability for members, employer groups, and the broader healthcare ecosystem. The role requires a highly strategic and influential leader who can translate complex financial, clinical, operational, and market dynamics into clear enterprise action and measurable results. This is not solely an analytics or reporting role. Success requires the ability to influence senior executives, align highly matrixed teams, challenge conventional thinking, and drive enterprise execution across clinical, operational, financial, and provider-facing functions. The ideal candidate brings deep expertise in healthcare affordability, medical economics, provider economics, value-based care, utilization management, and payer operations, along with the executive presence and communication skills necessary to operate effectively with the CEO, ELT, Board committees, regulators, and external partners. This leader will oversee and partner closely with the Medical Economics function and collaborate across Clinical Operations, Finance, Actuary, Product, Provider Partnerships, Government Programs, Population Health, Care Management, Pharmacy, and line-of-business leadership to identify affordability opportunities, drive accountability, and improve enterprise performance in a highly dynamic and evolving healthcare environment.

Requirements

• 10+ years of progressive executive leadership experience in healthcare affordability, medical economics, health plan finance, provider economics, or related areas
• Significant payer-side experience required, including demonstrated understanding of the interconnected impacts across utilization management, pharmacy, care management, provider economics, network strategy, and Total Cost of Care performance
• Demonstrated success driving measurable Total Cost of Care reduction initiatives in complex healthcare organizations
• Deep understanding of healthcare economics, utilization management, value-based care, provider reimbursement, and regulatory dynamics
• Strong executive communication and influence skills, with the ability to engage effectively across clinical, operational, financial, and executive audiences
• Proven ability to lead in highly matrixed, complex, and evolving organizations
• Strong strategic thinking, problem-solving, and organizational leadership capabilities
• Experience operating in Medicare Advantage, Medicaid, risk-based commercial, or value-based care environments strongly preferred
• Experience in turnaround, transformation, or cost-constrained environments preferred
• Master’s degree in Healthcare Administration, Business, Public Health, Economics, Data Science, or related field preferred
• Clinical background (MD, RN, PharmD) or actuarial credentials are valued but not required

Responsibilities

• Lead the development, refinement, and execution of a comprehensive enterprise affordability strategy focused on reducing Total Cost of Care across all lines of business
• Establish enterprise affordability priorities aligned to financial targets, regulatory expectations, competitive positioning, and member outcomes
• Partner with executive leadership to integrate affordability goals into operational planning, enterprise governance, and performance management processes
• Identify and prioritize the highest-impact affordability opportunities across clinical, operational, network, and product domains
• Serve as a trusted advisor to executive leadership on affordability trends, medical cost pressures, utilization patterns, and market dynamics
• Translate complex analytics and operational insights into clear executive recommendations and actionable next steps
• Lead enterprise-level discussions involving tradeoffs, prioritization, investment decisions, and affordability strategy execution
• Present affordability performance, emerging risks, and strategic recommendations to executive leadership and Board committees
• Oversee and partner closely with the Medical Economics team and related analytical functions to ensure affordability strategies are informed by robust data, actionable insights, and measurable outcomes
• Partner closely with Actuary, Finance, and analytics teams to assess medical cost performance, utilization trends, and affordability opportunities
• Establish transparent and consistent affordability reporting, measurement frameworks, and performance indicators across business lines
• Evaluate leading and lagging indicators to proactively identify affordability risks and intervention opportunities
• Partner with Clinical Operations, Care Management, Population Health, Pharmacy, and Government Programs leadership to optimize care models and improve affordability performance
• Identify opportunities to reduce avoidable utilization, improve care coordination, and strengthen outcomes for high-cost populations
• Ensure affordability initiatives support both business performance and high-quality, member-centered care delivery
• Integrate health equity considerations into affordability and care model strategies where appropriate
• Collaborate with Provider Partnerships, Finance, and Actuarial teams to strengthen value-based payment strategies and provider performance models
• Support provider incentive structures, risk-sharing arrangements, and network affordability initiatives aligned to enterprise TCOC goals
• Drive transparency, accountability, and partnership with providers around affordability outcomes and performance expectations
• Lead and influence teams across a highly matrixed enterprise environment
• Build strong cross-functional relationships and foster shared accountability for affordability outcomes
• Operate effectively in fast-paced, evolving, and complex environments requiring agility, sound judgment, and executive maturity
• Contribute to broader enterprise transformation and performance improvement efforts as a strategic leader

Benefits

• Medical, dental and vision coverage
• Retirement plans
• Paid time off
• Employer-paid life and disability insurance with additional buy-up coverage options
• Tuition program
• Well-being benefits
• Full suite of benefits to support career development, individual & family health, and financial health

What This Job Offers

• Job Type: Full-time
• Career Level: Executive