Partner - Medical Cost Optimization - Defined Path to Managing Partner

13

Point1 Advisors |

Location:

Flexible/Remote with Travel | Compensation:
Competitive Base + Performance Bonus + Equity The Opportunity

We are seeking a Partner-level candidate with deep subject matter expertise in Medical Cost Optimization to join our leadership team. This is not a traditional consulting role.
From day one, you will operate as a member of the executive team — bringing client relationships, shaping our go-to-market strategy, and building a high-performing team around a growing book of business.

This role carries a clear and supported path to Managing Partner over 3 years
, at which point you will own full P&L accountability for the Medical Cost Optimization practice, including revenue targets, client portfolio management, talent development, and market positioning.

If you are an experienced consulting leader who is ready to stop being a consultant and start being an owner, we want to talk.

• Originate, develop, and close new client engagements across health plan, managed care, and government payer segments
• Serve as a trusted advisor and executive-level relationship owner across a portfolio of payer clients
• Identify whitespace opportunities within existing accounts and convert them into expanded engagements
• Represent the firm at industry conferences, forums, and through thought leadership publications
• Define and execute the strategic roadmap for the Firm, including service offerings, pricing, and competitive positioning
• Collaborate with firm leadership to set annual revenue and margin targets, and be accountable for delivering against them
• Develop proposals, respond to RFPs, and lead client presentations at the C-suite level

• Oversee the quality and impact of all engagements, ensuring clients achieve measurable financial and operational outcomes across the medical cost spectrum
• Serve as executive sponsor on complex, multi-workstream projects spanning:
• Payment Integrity — claims auditing, COB, subrogation, FWA, DRG validation, clinical editing, prepay/post-pay strategy
• Network Strategy — provider network design, tiering, contracting, unit cost benchmarking, and value-based arrangement structuring
• Clinical Program Effectiveness — disease management, specialty pharmacy cost management, high-cost claimant programs, and behavioral health integration
• Cost Trend Analytics — medical cost driver analysis, MLR improvement, reserve accuracy, and actuarial partnership
• Resolve escalations and manage client satisfaction across the portfolio

• Recruit, mentor, and retain top consulting talent within the Medical Cost Optimization practice
• Build a team culture centered on subject matter depth, client impact, and professional growth
• Contribute to firm-wide recruiting and capability-building initiatives

Required Experience

• 12+ years of progressive experience in health plan operations, medical economics, or healthcare consulting
• Demonstrated expertise across multiple Medical Cost Optimization domains, with particular depth in one or more of the following:
• Payment Integrity (claims editing, FWA, COB, subrogation, DRG validation, provider contract compliance)
• Utilization Management and care management program design
• Provider network strategy, contracting, and value-based care arrangements
• Medical cost trend analysis and MLR improvement
• Specialty pharmacy and high-cost claimant management
• Proven track record of originating and managing client relationships — you have brought clients with you before, or have a defined network from which to build
• Experience working with or within health plans, managed care organizations, or Blues plans
• Deep familiarity with regulatory frameworks including CMS, NAIC, state Medicaid requirements, and ACA compliance

Preferred Experience

• Prior experience in a consulting firm at the Manager, Director, or Principal level
• Experience managing a P&L or practice area budget
• Relationships with VP- and C-level decision-makers at regional or national health plans
• Exposure to cost management technology vendors and platforms (e.g., Cotiviti, Zelis, Multi Plan, Evolent, Crimson, Clarify Health)