Director

Summary

Join Hello Heart as their Director, Actuarial Services, collaborating with customers, consultants, and payers to create and present health economic and benefit analyses. As a key team member, you will serve as an expert in meetings and speaking events, create health economics and outcomes research, lead efforts on performance guarantees and reserving, and support commercial activities. This role involves analyzing medical claims data, communicating findings, and collaborating with internal teams. You will be the company’s actuarial voice with external stakeholders and help develop new client opportunities. The position reports to the Senior Vice President, Medical Affairs and requires significant expertise in actuarial science and healthcare.

Requirements

• Possess comprehensive knowledge of actuarial principles, concepts, practices, and processes
• 5+ years of actuarial experience in a healthcare organization/health insurer
• Bachelor's degree in Actuarial Science, Mathematics, Statistics, or a related field
• Associate of the Society of Actuaries (ASA) certification or Fellow of the Society of Actuaries (FSA)
• Analytical, communication (oral & written), and problem-solving skills, including comfort presenting in an engaging, charismatic manner to large audiences
• Comfort leveraging medical claims, pharmacy claims (including measurement of proportion of days covered), and other large data sets
• Understanding of Medicare Advantage Star Ratings/quality metrics and experience with auditors of the same
• Ability to work independently and collaboratively in a fast-paced, start-up environment
• Willingness to travel up to 20% of the time

Responsibilities

• Serve as an expert in meetings and speaking events, including conferences, trade shows, and prospect/client meetings
• Lead the development of studies, analyses, and presentation materials for external decision-makers and publication
• Comfort leveraging/working with medical claims (e.g., paid vs. allowed amounts, etc.), pharmacy claims (including measurement of proportion of days covered), and other large data sets
• Lead efforts on performance guarantees, including maintaining meaningful offerings, ensuring adequate reserves, and training other internal stakeholders on our offering
• Driving efforts around specialty incentives, for example supporting efforts in value-based contracting
• Serve as point of contact for external cost savings studies with consultants or other partners
• Supporting new product launches with analyses of expected clinical and financial impact
• Identify new market opportunities where an actuarial voice will advance positioning
• Partner with other members of the medical affairs team on strategic planning
• Represent the company and its services to external audiences
• Provide health economic subject matter expertise relevant to the company’s teams and services
• Advocate across the company for appropriate positions, processes, and systems
• Manage own time and resources across projects, focusing on quality, time, scope, usefulness, and appropriateness of work
• Use effective communication to present information and provide decision support
• Represent actuarial perspectives in cross-disciplinary settings, including at times presenting to larger audiences
• Track health industry and competitor trends
• Communicate complex statistical material clearly to external stakeholders, internal teams, and public relations

Benefits

The US base salary range for this full-time position is $180,000 to $200,000