Principal Actuary

This is a fully remote position, open to applicants in United States.

📋 Description

• Develop Omada Health’s internal actuarial capabilities and define how the organization measures, communicates, and prices the economic value of its offerings.

• Create ROI models for Medicare and government sectors and assist with analyses related to Star Ratings and future program evaluations.

• Design and price performance guarantees and at-risk agreements, including pricing and exposure models, triggers, measurement criteria, and actuarial safeguards.

• Act as the actuarial representative in finalist meetings, RFPs, and renewals with payers, employers, and benefits consultants.

• Model and oversee performance guarantee exposure across the customer portfolio, providing accrual and reserve inputs to the Accounting team.

• Evaluate pricing and unit economics, including GLP-1 utilization, pharmacy trends, and medical trends.

• Establish reusable, version-controlled models and documentation methodologies.

• Enhance actuarial knowledge across Finance, Strategy, Commercial, and Clinical areas while supporting audit and disclosure processes.

• Independently determine actuarial methodologies and evaluate guarantee soundness while collaborating on pricing, contract terms, risk acceptance, accounting conclusions, and external claims governance.

• Report to the VP of Strategic Finance and collaborate with Finance, Clinical, Commercial, and Strategy teams.

⛳️ Requirements

• ASA or FSA designation from the Society of Actuaries, in good standing.

• Bachelor’s degree in actuarial science, mathematics, statistics, economics, or a related quantitative discipline.

• A minimum of 10 years of actuarial experience in the healthcare sector, including Medicare Advantage, government markets, payer services, consulting, or within a risk-bearing digital health or provider organization.

• Practical experience with medical and pharmacy claims, including the creation of matched-cohort and claims-based savings studies that have successfully passed third-party scrutiny.

• Experience in designing or evaluating performance guarantees, shared savings models, ROI, or other value-based frameworks, including the quantification of downside risks.

• Proficient in SQL and advanced Excel, with the capability to independently extract data, create models, and validate findings.

• Significant experience utilizing AI in analytical processes, with clear validation of outcomes and proper management of confidential information.

• Capability to present and defend methodologies to payer actuaries, analysts, benefits consultants, and finance leaders within employer organizations.

• Demonstrated intellectual honesty, commercial acumen, and effective written communication skills.

• Bonus: FSA and MAAA credentials, knowledge of GLP-1 and pharmacy trend economics, experience in Medicare or government markets, digital health, or point solution vendors, as well as proficiency in Python or R, and a background in actuarial consulting.

🏝️ Benefits

• Competitive salary with a 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 with above-market employer contributions.

• 401k retirement savings plan.

• Lifestyle Spending Account (LSA).

• Mental Health Support Solutions.