Director, Actuarial Services

🔥 17 hours ago

🇺🇸 United States – Remote

💵 $200k - $225k / year

⏰ Full Time

🔴 Lead

📊 Actuary

👻 Ghost score 0%

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Hello Heart

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 2013

🏥 Healthcare

💼 Consulting

🧘 Wellness

Healthcare • Consulting • Wellness

Hello Heart is a healthcare technology company offering a mobile app to help individuals track and improve their heart health. The app provides real-time tips, allows users to track their blood pressure, and offers personalized insights to help users manage their heart health more effectively. Hello Heart also partners with businesses, health plans, and labor unions to provide these tools to their employees and members, demonstrating a significant impact on heart health outcomes through personalized and data-driven approaches. Privacy and security of health data are prioritized, ensuring members' health information is protected.

📋 Description

• Partner with Sales, Consultant Relations, and Customer Success to strengthen proposals and communicate Hello Heart's economic value • Join client and consultant calls, performance reviews, and renewal value conversations as a client-facing actuarial expert • Advocate for sound actuarial practices, appropriate methodologies, and effective analytical processes • Provide strategic guidance on healthcare economics, financial outcomes, pricing, and market opportunities • Lead health economic studies, cost savings analyses, and outcomes research • Analyze medical claims, pharmacy claims, and other large datasets to evaluate utilization, medication adherence, costs, and financial outcomes • Develop and maintain performance guarantee offerings, assess financial risks, oversee reserves, and educate internal stakeholders • Develop risk-based pricing approaches and support value-based contracting and specialty incentive opportunities • Present actuarial and health economic findings to customers, consultants, payers, industry audiences, and conferences • Serve as primary actuarial contact for independent cost savings studies, research collaborations, and external analyses • Evaluate clinical and financial impacts of new products and services and provide actuarial input into strategic planning • Develop executive-ready presentations, research materials, and publications • Track healthcare market dynamics, competitor trends, Medicare Advantage quality measures, and emerging reimbursement models

🎯 Requirements

• 7+ years of actuarial experience within healthcare, health insurance, or a related healthcare organization, including health economic and financial analyses • Client-facing or sales-support experience, such as consulting or startup experience • Deep knowledge of actuarial principles, healthcare economics, risk assessment, and statistical methodologies • Proficiency in R • Experience analyzing large medical and pharmacy claims datasets, including paid and allowed amounts, healthcare utilization, and medication adherence measures • Ability to leverage artificial intelligence tools and agents for research, analysis, reporting, and complex workflows while evaluating outputs for accuracy and reliability • Bachelor's degree in Mathematics, Statistics, Economics, Actuarial Science, or a related field • Associate of the Society of Actuaries (ASA) or Fellow of the Society of Actuaries (FSA) credential • Experience developing or evaluating healthcare cost savings studies, financial outcomes research, performance guarantees, and risk-based pricing models • Understanding of risk adjustment, Medicare Advantage Star Ratings, healthcare quality metrics, and related audit processes • Strong written and verbal communication skills • Ability to influence cross-functional stakeholders, manage competing priorities, and independently drive high-impact initiatives • Willingness to travel up to 20% of the time

🏖️ Benefits

• Annual salary and bonus compensation • Positive, diverse, and supportive culture • Collaborative, creative, and courageous work environment

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