Vice President, Affordability R9240

Who We Are

Point32Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable healthcare. Serving nearly 2 million members, Point32Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for everyone. Our culture revolves around being a community of care and having shared values that guide our behaviors and decisions. Weve had a long-standing commitment to inclusion and equal healthcare access and outcomes, regardless of background; its at the core of who we are. We value the rich mix of backgrounds, perspectives, and experiences of all of our colleagues, which helps us to provide service with empathy and better understand and meet the needs of the communities where we serve, live, and work.

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

Job Summary

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.
Job Description

What We Need

We are seeking an executive who can:

Translate complex affordability and utilization trends into actionable enterprise strategies and operational decisions

Influence senior leaders and drive alignment across highly matrixed environments

Balance financial, operational, clinical, regulatory, and member experience considerations simultaneously

Lead through ambiguity, complexity, and organizational transformation

Communicate difficult tradeoffs and recommendations with clarity, credibility, and executive presence

Build strong partnerships while holding teams accountable for measurable affordability outcomes

Operate as an enterprise strategist not simply a functional affordability expert

Understand the interconnected impacts across utilization management, pharmacy, provider economics, care management, network strategy, and Total Cost of Care performance

Key Responsibilities

Enterprise Affordability Strategy

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 outco