Principal Actuary

Overview

The organization is seeking a Principal Actuary to build internal actuarial capability and establish how the team measures, communicates, and prices the economic value of programs. Reporting to the VP of Strategic Finance, this is a hands-on individual contributor role partnering across Finance, Clinical, Commercial, and Strategy.

Responsibilities

• Partner with Clinical and Commercial teams to develop ROI models for Medicare and government markets.
• Support analyses related to Star Ratings and inform future studies and evaluations of programs and services.
• Design and price performance guarantees and at-risk terms, including:
  • Building pricing and exposure models
  • Defining clear triggers and measurement terms
  • Establishing actuarial guardrails for customer commitments
• Serve as the actuarial voice in finalist meetings, RFPs, and renewals with payers, employers, and benefits consultants; explain and defend measurement methodology directly with payer actuaries and analysts.
• Model and monitor performance guarantee exposure across the customer portfolio, and identify contracts at risk; provide accrual and reserve inputs to Accounting.
• Pressure-test pricing and unit economics, including the effects of GLP-1 utilization, pharmacy trend, and medical trend on programs and customers.
• Establish reusable, version-controlled models and methodology documentation.
• Build actuarial understanding across Finance, Strategy, Commercial, and Clinical, and support audit and disclosure review.
• Independently set actuarial methodology and assess guarantee soundness, partnering through existing governance for final pricing, contract terms, material risk acceptance, accounting conclusions, and external claims.

Requirements

• ASA or FSA designation from the Society of Actuaries, in good standing.
• Bachelor’s degree in actuarial science, mathematics, statistics, economics, or a comparable quantitative field.
• 10 or more years of healthcare actuarial experience across Medicare Advantage, government markets, payer, consulting, or a risk-bearing digital health or provider organization.
• Hands-on experience with medical and pharmacy claims, including building matched-cohort and claims-based savings studies that have withstood third-party scrutiny.
• Experience designing or evaluating performance guarantees, shared savings, ROI, or other value-based arrangements, including quantifying downside exposure.
• Strong SQL and advanced Excel skills, including independent data extraction, model building, and result validation.
• Strong experience using AI in analytical workflows, with clear validation of outputs and appropriate handling of confidential information.
• Ability to present and defend methodology to payer actuaries and analysts, benefits consultants, and employer finance leaders.
• Demonstrated intellectual honesty and commercial judgment, with clear written communication; ability to challenge unsupported assumptions constructively, distinguish evidence from uncertainty, and translate complex analysis into decisions without compromising methodological integrity.

Preferred Qualifications

• FSA and MAAA credentials rather than ASA alone.
• Direct experience with GLP-1 and pharmacy trend economics, including specialty drug management.
• Experience in Medicare or government markets, including Medicare Advantage, Medicaid managed care, or risk adjustment methodologies.
• Experience at a digital health or point solution vendor selling into employers and payers.
• Python or R for modeling and automation, and/or an actuarial consulting background spanning multiple client methodologies.

Compensation & Benefits

• Competitive salary with generous annual cash bonus.
• Equity grants.
• Employee stock purchasing plan (ESPP).
• Remote-first work from home.
• Flexible Time Off.
• Generous parental leave.
• Health, dental, and vision insurance (and above-market employer contributions).
• 401k retirement savings plan.
• Lifestyle Spending Account (LSA).
• Mental Health Support Solutions.

Salary Ranges (by Geographic Zone)

• Zone 1: $228,160 - $285,200
• Zone 2: $218,240 - $272,800
• Zone 3: $198,400 - $248,000

Compensation will be within the posted range for the relevant zone and determined based on multiple factors, including candidate skills and experience and other business considerations such as internal equity.