Principal Actuary
New
J
JobgetherDigital health
Applicants must reside within the 50 states of the United States.Full-TimePrincipal
SalaryAnnual base salary ranges vary by geographic zone: Zone 1: $228,160–$285,200; Zone 2: $218,240–$272,800; Zone 3: $198,400–$248,000. Annual Cash Bonus: Eligibility for a competitive annual cash bonus. Equity Opportunities: Equity grants that provide an opportunity to participate in the organization's long-term growth.
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Job Details
- Experience
- At least 10 years of healthcare actuarial experience
- Required Skills
- SQLArtificial IntelligenceMicrosoft Excel
Requirements
- Hold an Associate or Fellow of the Society of Actuaries (ASA or FSA) designation in good standing.
- Have a bachelor's degree in actuarial science, mathematics, statistics, economics, or another relevant quantitative discipline.
- Have at least 10 years of healthcare actuarial experience across Medicare Advantage, government healthcare programs, payer organizations, actuarial consulting, or risk-bearing digital health or provider organizations.
- Have hands-on experience with medical and pharmacy claims data, including personally building matched-cohort analyses and claims-based savings studies that withstand independent or third-party scrutiny.
- Have experience designing, pricing, or evaluating performance guarantees, shared-savings arrangements, ROI guarantees, or other value-based commercial models, including quantifying downside financial exposure.
- Demonstrate strong SQL capabilities and advanced Microsoft Excel skills for independently extracting, analyzing, modeling, and validating data.
- Have experience incorporating AI into analytical workflows and validating outputs, assessing reliability, and appropriately handling confidential and sensitive information.
- Have a strong understanding of healthcare cost drivers, medical and pharmacy trends, and the financial dynamics of healthcare programs.
- Be able to assess pricing structures, quantify financial risk, evaluate contractual guarantees, and balance commercial objectives with methodological rigor and financial sustainability.
- Be confident presenting and defending complex actuarial methodologies to payer actuaries, analysts, benefits consultants, employer finance leaders, and internal executives.
Responsibilities
- Build and refine actuarial models measuring program savings, financial performance, and return on investment.
- Develop ROI methodologies for Medicare and government markets and support Star Ratings analyses.
- Design and price performance guarantees, shared-savings arrangements, and other at-risk commercial agreements.
- Build claims-based savings studies using medical and pharmacy claims data, including matched-cohort analyses.
- Represent the actuarial function in finalist presentations, RFP processes, contract renewals, and customer discussions.
- Model and monitor performance guarantee exposure across the customer portfolio and provide accrual and reserve inputs to Accounting.
- Evaluate pricing assumptions and unit economics, including medical and pharmacy cost trends, GLP-1 utilization, and specialty drug management.
- Establish reusable, version-controlled actuarial models and document methodologies, assumptions, and validation procedures.
- Apply advanced analytical techniques and AI-enabled tools to improve modeling efficiency while validating outputs and protecting confidential information.
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