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Role Summary

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HIGHLIGHTS

Senior health actuary role focused on value-based care and commercial contracting in San Francisco. You will build and defend BCAs, model financial risk for at‑risk contracts (MA, Fully Insured, ASO), and negotiate methodology with payer actuarial teams to drive large ARR deals.

JOB DESCRIPTION SUMMARY

  • Own actuarial strategy for value-based care and shared-risk contracting
  • Build and defend Business Case Analyses using claims and benchmark data
  • Model reserves and pricing for at-risk contracts (MA, Fully Insured, ASO)
  • Partner with Sales, Clinical Research, Finance, and external payers
  • Senior individual contributor with 8+ years in health insurance

DOMAIN EXPERTISE

  • Claims data analysis
  • Pricing and underwriting in health insurance
  • Medicare Advantage, Fully Insured, and ASO financial models
  • Negotiating methodology with health plan actuaries

KEY REQUIREMENTS

  • Bachelor's degree in Actuarial Science required
  • 8+ years of health insurance experience with claims analysis
  • Deep expertise in Medicare Advantage, Fully Insured, and ASO models
  • Proven experience negotiating actuarial methodology with payers
  • Strong financial modelling and stakeholder communication skills

TECH STACK

  • Excel
  • Databricks
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Role Summary

Loading...

HIGHLIGHTS

Senior health actuary role focused on value-based care and commercial contracting in San Francisco. You will build and defend BCAs, model financial risk for at‑risk contracts (MA, Fully Insured, ASO), and negotiate methodology with payer actuarial teams to drive large ARR deals.

JOB DESCRIPTION SUMMARY

  • Own actuarial strategy for value-based care and shared-risk contracting
  • Build and defend Business Case Analyses using claims and benchmark data
  • Model reserves and pricing for at-risk contracts (MA, Fully Insured, ASO)
  • Partner with Sales, Clinical Research, Finance, and external payers
  • Senior individual contributor with 8+ years in health insurance

DOMAIN EXPERTISE

  • Claims data analysis
  • Pricing and underwriting in health insurance
  • Medicare Advantage, Fully Insured, and ASO financial models
  • Negotiating methodology with health plan actuaries

KEY REQUIREMENTS

  • Bachelor's degree in Actuarial Science required
  • 8+ years of health insurance experience with claims analysis
  • Deep expertise in Medicare Advantage, Fully Insured, and ASO models
  • Proven experience negotiating actuarial methodology with payers
  • Strong financial modelling and stakeholder communication skills

TECH STACK

  • Excel
  • Databricks

Job Overview

Salary
$170k - $254k
Years of Experience
8+ Years
Work Type
Permanent
Full Time

Ideal Candidate Profile

Ideal for a senior health actuary with 8+ years in payer environments, strong Medicare Advantage and ASO experience, and the ability to negotiate ROI/methodology with external actuaries while building claims-based models.

Benefits

Health InsuranceDental InsuranceVision Insurance401(k) PlanTraining Budget
Fresh Role
Premium Window
0d
Posted Today

Strategy: Maximize Application Quality

Applications submitted within 72 hours are 2x more likely to land an interview.

"Recruiters are actively watching. Take time to tailor your keywords."

Job Overview

Salary
$170k - $254k
Years of Experience
8+ Years
Work Type
Permanent
Full Time

Ideal Candidate Profile

Ideal for a senior health actuary with 8+ years in payer environments, strong Medicare Advantage and ASO experience, and the ability to negotiate ROI/methodology with external actuaries while building claims-based models.

Benefits

Health InsuranceDental InsuranceVision Insurance401(k) PlanTraining Budget
Fresh Role
Premium Window
0d
Posted Today

Strategy: Maximize Application Quality

Applications submitted within 72 hours are 2x more likely to land an interview.

"Recruiters are actively watching. Take time to tailor your keywords."

Health/Insurtech/IC Level
H

Actuary

Hinge Health•San Francisco, California, United States•4h ago
Medicare AdvantageCommercial Employer HealthHealth OtherPricing & RatingProduct Development & Plan DesignPredictive Modelling & ML

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