Own savings forecasts and monthly financial close for all value-based contracts, including shared savings accruals, reserves, and IBNR development.
Build and maintain financial models capturing performance drivers under MLR-based and RCT-based contract structures; monitor cost trends and provide early warnings of variances with recommended actions.
Serve as the technical authority on total cost of care projections, conducting and reviewing sophisticated analyses, cost trend studies, and actuarial modeling as needed.
Lead year-end contract reconciliation with health plan actuaries and provide actuarial/financial guidance during contract negotiations.
Develop underwriting frameworks (MLR targets, performance guarantees, risk corridors) and build methodologies to accurately measure organizational performance across contract structures.
Perform deep-dive cost trend analyses to identify clinical impact opportunities; generate insights that drive clinical model innovation and support strategic planning across market opportunities and growth scenarios.
Serve as the primary technical counterpart to health plan actuaries during data validation, reconciliation, and negotiations.
Lead discussions to resolve methodology differences and communicate findings clearly to non-technical stakeholders.
Develop compelling value narratives and analytical exhibits that translate complex medical economics findings into actionable recommendations.
Build, grow, and lead a best-in-class medical economics and actuarial function.
Develop analytical tools, data infrastructure, and reporting frameworks that improve team efficiency and scale capabilities.
Dive deep into data quality issues and work cross-functionally to resolve discrepancies; write analytical memos and reports that communicate findings to senior leadership.

Requirements

Advanced degree in a quantitative field (actuarial science, statistics, mathematics, economics, public health, or related)
10+ years of progressive experience in health actuarial science or medical economics, with at least 3-5 years in a leadership role
Demonstrable expertise in Medicaid, including capitation, risk adjustment, MLR requirements, and regulatory frameworks
Proven track record with value-based care arrangements, shared savings contracts, and risk-bearing models, including contract underwriting, performance forecasting, and financial reconciliation
Expert-level proficiency in actuarial and medical economics methodologies (reserving, pricing, trend analysis, total cost of care modeling); strong SQL, Python, and/or R skills; advanced Excel/financial modeling; and experience with large, complex healthcare datasets
Demonstrated ability to build and lead high-performing analytical teams in growth-stage organizations, with exceptional communication skills across technical and non-technical audiences
Equal parts strategic thinker and hands-on executor — able to build vision and infrastructure while personally conducting sophisticated analyses
Comfortable with ambiguity, fast-moving priorities, and building effective cross-functional partnerships.

Benefits

Stock Options: Opportunity to invest in the company’s growth.
Work-from-Home Stipend: A dedicated stipend for your first year to help set up your home office.
Medical, Vision, and Dental Coverage: Comprehensive plans to keep you and your family healthy.
Life Insurance: Basic life insurance to give you peace of mind.
Paid Time Off: 20 vacation days, accrued over the year, plus 11 paid holidays.
Parental Leave: 16 weeks of paid leave for birthing parents after six months of employment, and 8 weeks of bonding leave for non-birthing parents.
Retirement Savings: Access to a 401(k) plan with a company contribution, subject to a vesting schedule.
Commuter Benefits: Convenient options to support your commute needs.
Professional Development Stipend: A dedicated stipend supports professional development and growth.

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools

actuarial sciencestatisticsmathematicseconomicspublic healthMedicaidfinancial modelingSQLPythonR

Soft Skills

leadershipcommunicationstrategic thinkinganalytical skillsproblem-solvingcross-functional collaborationadaptabilityteam buildingdata analysisnegotiation