Director, Actuarial Services

Tuesday

Director leading actuarial services for Tuesday Health, a value-based palliative care provider. Owning settlements, underwriting, claims reporting, and payer negotiations for risk-bearing contracts.

Posted 8/5/2026full-timeRemote • 🇺🇸 United StatesLeadWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in actuarial analysis for value-based care, including settlement calculations, risk assessment, and financial projections. Proficient in claims data analysis and effective communication of complex findings to diverse audiences.

Highest-signal resume keywords

Actuarial Experience in Value-Based CareClaims Data AnalysisSettlement Calculations and Financial ReconciliationsPayer Contract NegotiationsSQL for Large Claims Datasets

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Settlement CalculationsFinancial ReconciliationsRisk AssessmentClaims Data AnalysisPricing AnalysisActuarial AssumptionsCost and Utilization AnalysisActuarial SoundnessStatistical AnalysisQuantitative Analysis

Soft Skills

Strong Written CommunicationStrong Verbal CommunicationMentoringCollaborationTechnical Discussion Facilitation

Tools & Technologies

SQLData Analytics ToolsClaims Reporting Systems

Certifications & Qualifications

Fellow of the Society of Actuaries (FSA)Associate of the Society of Actuaries (ASA)Member of the American Academy of Actuaries (MAAA)

Industry Keywords

Value-Based ContractsAlternative Payment ModelsRisk-Bearing ArrangementsHealthcare Actuarial AnalysisCMS Alternative Payment ModelsMedicare Advantage Risk-Adjustment

Tech Stack

Tools & technologies

SQL

About the role

Key responsibilities & impact

Lead customer settlement calculations for value-based contracts, reconciling actual performance against contractual targets such as shared savings, shared risk, and total cost of care benchmarks
Support health plan and payer contract negotiations through actuarial analyses of proposed terms, risk arrangements, benchmarks, and financial projections
Own underwriting for new and renewing contracts, including pricing analysis, population and market risk assessment, and actuarial assumptions for growth and expansion
Produce claims-based reporting on cost, utilization, and quality metrics for internal leadership and external customers
Lead claims-trend analyses, identify cost and utilization drivers, and translate findings into clinical, operational, and growth strategy input
Maintain actuarial soundness of financial projections, reserves, and risk assessments for value-based and risk-bearing arrangements
Partner with Data & Analytics and Medical Economics to validate claims and utilization data
Represent Tuesday Health in technical discussions with payer-side actuaries and analytics teams
Build and mentor actuarial and analytical capabilities and establish repeatable methodologies and documentation

Requirements

What you’ll need

Substantial actuarial experience in value-based care, alternative payment models, or other risk-bearing healthcare arrangements
Hands-on experience with claims-based underwriting, pricing, and risk assessment for provider organizations, payers, or risk-bearing entities
Experience leading or directly performing settlement calculations and financial reconciliations under value-based contracts
Experience supporting payer contract negotiations with actuarial and financial analysis
Strong claims data analysis skills, including identifying and explaining cost and utilization trends
Bachelor's degree in actuarial science, mathematics, statistics, economics, or a related quantitative field
Strong written and verbal communication skills and ability to explain actuarial findings to non-actuarial audiences
Preferred: Fellow (FSA) or Associate (ASA) of the Society of Actuaries and Member of the American Academy of Actuaries (MAAA)
Preferred: Experience in complex/high-acuity value-based populations
Preferred: Experience with CMS alternative payment models or Medicare Advantage risk-adjustment methodologies
Preferred: Experience with SQL or similar tools for large claims datasets
Preferred: Experience managing or mentoring actuarial or analytical staff

Benefits

Comp & perks

Comprehensive benefits including medical, dental, vision, and life insurance
Paid time off and holidays
Employer 401(k) match
Remote work with multiple onsite sessions each year
Dynamic and inclusive team environment
Meaningful work supporting seriously ill individuals and their caregivers