Director, Actuarial Services

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🔥 3 hours ago

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Tuesday

WebsiteLinkedInAll Job Openings

1 - 10 employees

🤲 Charity

🤝 Non-profit

☁️ SaaS

Charity • Non-profit • SaaS

Tuesday is a company that offers a fundraising software platform specifically designed for nonprofits and changemakers. The Tuesday app provides a social platform that enables nonprofits to engage their networks in a fun and impactful nonprofit auction shopping experience aimed at supporting humanitarian causes. With user-friendly digital fundraising technology, Tuesday centralizes fundraising management through state-of-the-art donation management tools, making it easier for organizations like Meals on Wheels and Aga Khan Foundation to grow their impact through auctions and donation campaigns. Tuesday is dedicated to giving back every day with its nonprofit-first technology.

📋 Description

• Lead customer settlement calculations for value-based contracts, reconciling actual performance against contractual targets such as shared savings, shared risk, and total cost of care benchmarks • Support health plan and payer contract negotiations through actuarial analyses of proposed terms, risk arrangements, benchmarks, and financial projections • Own underwriting for new and renewing contracts, including pricing analysis, population and market risk assessment, and actuarial assumptions for growth and expansion • Produce claims-based reporting on cost, utilization, and quality metrics for internal leadership and external customers • Lead claims-trend analyses, identify cost and utilization drivers, and translate findings into clinical, operational, and growth strategy input • Maintain actuarial soundness of financial projections, reserves, and risk assessments for value-based and risk-bearing arrangements • Partner with Data & Analytics and Medical Economics to validate claims and utilization data • Represent Tuesday Health in technical discussions with payer-side actuaries and analytics teams • Build and mentor actuarial and analytical capabilities and establish repeatable methodologies and documentation

🎯 Requirements

• Substantial actuarial experience in value-based care, alternative payment models, or other risk-bearing healthcare arrangements • Hands-on experience with claims-based underwriting, pricing, and risk assessment for provider organizations, payers, or risk-bearing entities • Experience leading or directly performing settlement calculations and financial reconciliations under value-based contracts • Experience supporting payer contract negotiations with actuarial and financial analysis • Strong claims data analysis skills, including identifying and explaining cost and utilization trends • Bachelor's degree in actuarial science, mathematics, statistics, economics, or a related quantitative field • Strong written and verbal communication skills and ability to explain actuarial findings to non-actuarial audiences • Preferred: Fellow (FSA) or Associate (ASA) of the Society of Actuaries and Member of the American Academy of Actuaries (MAAA) • Preferred: Experience in complex/high-acuity value-based populations • Preferred: Experience with CMS alternative payment models or Medicare Advantage risk-adjustment methodologies • Preferred: Experience with SQL or similar tools for large claims datasets • Preferred: Experience managing or mentoring actuarial or analytical staff

🏖️ Benefits

• Comprehensive benefits including medical, dental, vision, and life insurance • Paid time off and holidays • Employer 401(k) match • Remote work with multiple onsite sessions each year • Dynamic and inclusive team environment • Meaningful work supporting seriously ill individuals and their caregivers