Principal Actuary

Job not on LinkedIn

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $198.4k - $285.2k / year

⏰ Full Time

🔴 Lead

📊 Actuary

🦅 H1B Visa Sponsor

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Omada Health

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2011

🏥 Healthcare

⚕️ Healthcare Insurance

🧘 Wellness

💰 $192M Series E on 2022-02

Healthcare • Healthcare Insurance • Wellness

Omada Health is a virtual care company focused on helping individuals achieve their health goals through personalized support and programs. The company offers comprehensive health management solutions for conditions like diabetes, hypertension, and musculoskeletal health. Omada provides one-on-one health coaching and smart devices to monitor and improve health, creating personalized care plans for its users. Its programs are designed to be accessible at no cost to participants when covered by their employer or health plan, making Omada a leader in delivering quality virtual care that is both personal and sustainable.

📋 Description

• Build Omada Health’s internal actuarial capability and establish how the company measures, communicates, and prices the economic value of its programs. • Develop ROI models for Medicare and government markets and support analyses related to Star Ratings and future program studies. • Design and price performance guarantees and at-risk terms, including pricing and exposure models, triggers, measurement terms, and actuarial guardrails. • Serve as the actuarial voice in finalist meetings, RFPs, and renewals with payers, employers, and benefits consultants. • Model and monitor performance guarantee exposure across the customer portfolio and provide accrual and reserve inputs to Accounting. • Pressure-test pricing and unit economics, including GLP-1 utilization, pharmacy trend, and medical trend. • 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 while partnering through governance on pricing, contract terms, risk acceptance, accounting conclusions, and external claims. • Report to the VP of Strategic Finance and partner across Finance, Clinical, Commercial, and Strategy.

🎯 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, with the ability to independently extract data, build models, and validate results. • 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. • Intellectual honesty, commercial judgment, and clear written communication. • Bonus: FSA and MAAA credentials, GLP-1 and pharmacy trend economics, Medicare or government markets, digital health or point solution vendor experience, Python or R, actuarial consulting background.

🏖️ Benefits

• Competitive salary with generous annual cash bonus • Equity grants • Employee stock purchasing plan (ESPP) • Remote first work from home culture • 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