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Role Summary

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HIGHLIGHTS

Senior health actuarial role focused on value-based care and MSK digital health at Hinge Health in San Francisco. You will own claims-based ROI and reserve modelling, negotiate performance guarantees with large payers, and design risk-transfer and shared-savings arrangements. The role requires deep payer experience and strong claims-data and financial modelling skills.

JOB DESCRIPTION SUMMARY

  • Serve as actuarial SME for value-based care contracts with large health plans
  • Model financial risk, reserves, and shared-savings/shared-risk arrangements
  • Audit and standardize claims data analysis using Databricks and Excel
  • Frequent client-facing work negotiating validation frameworks and guarantees
  • San Francisco-based senior role requiring 8+ years in health insurance

DOMAIN EXPERTISE

  • Claims data analysis for health insurers
  • Pricing and underwriting for Medicare Advantage and ASO models
  • Negotiating value-based care/shared-savings contracts
  • Experience working with large payer organizations (Optum, UHG, Anthem)
  • Familiarity with healthcare data warehouses (Databricks) and claims datasets

KEY REQUIREMENTS

  • Bachelor's degree in Actuarial Science required
  • 8+ years of experience in health insurance (pricing, claims, underwriting)
  • Proven experience with large payer organizations and MA/ASO/fully insured models
  • Advanced financial modelling in Excel and experience with claims data/Databricks
  • Ability to present and negotiate with Chief Actuaries and C-suite stakeholders

TECH STACK

  • Excel
  • Databricks
  • PowerPoint
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Role Summary

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HIGHLIGHTS

Senior health actuarial role focused on value-based care and MSK digital health at Hinge Health in San Francisco. You will own claims-based ROI and reserve modelling, negotiate performance guarantees with large payers, and design risk-transfer and shared-savings arrangements. The role requires deep payer experience and strong claims-data and financial modelling skills.

JOB DESCRIPTION SUMMARY

  • Serve as actuarial SME for value-based care contracts with large health plans
  • Model financial risk, reserves, and shared-savings/shared-risk arrangements
  • Audit and standardize claims data analysis using Databricks and Excel
  • Frequent client-facing work negotiating validation frameworks and guarantees
  • San Francisco-based senior role requiring 8+ years in health insurance

DOMAIN EXPERTISE

  • Claims data analysis for health insurers
  • Pricing and underwriting for Medicare Advantage and ASO models
  • Negotiating value-based care/shared-savings contracts
  • Experience working with large payer organizations (Optum, UHG, Anthem)
  • Familiarity with healthcare data warehouses (Databricks) and claims datasets

KEY REQUIREMENTS

  • Bachelor's degree in Actuarial Science required
  • 8+ years of experience in health insurance (pricing, claims, underwriting)
  • Proven experience with large payer organizations and MA/ASO/fully insured models
  • Advanced financial modelling in Excel and experience with claims data/Databricks
  • Ability to present and negotiate with Chief Actuaries and C-suite stakeholders

TECH STACK

  • Excel
  • Databricks
  • PowerPoint

Job Overview

Salary
$138k - $206k
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 (Medicare Advantage, ASO) and strong claims-data and financial modelling skills; FSA preferred and able to negotiate value-based contracts with C-suite and chief actuaries.

Benefits

Health InsuranceDental InsuranceVision Insurance401(k) PlanWellness Program
Fresh Role
Premium Window
1d
1 days ago

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
$138k - $206k
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 (Medicare Advantage, ASO) and strong claims-data and financial modelling skills; FSA preferred and able to negotiate value-based contracts with C-suite and chief actuaries.

Benefits

Health InsuranceDental InsuranceVision Insurance401(k) PlanWellness Program
Fresh Role
Premium Window
1d
1 days ago

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."

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