Director, Actuarial Services

The role

The Director, Actuarial Services will deliver actuarial strategy, health economic analyses, and financial value demonstration. This person will translate complex healthcare data into insights to demonstrate the clinical and financial value of the heart health solution.

What you will do

• Partner with Sales, Consultant Relations, and Customer Success to strengthen proposals.
• Join client and consultant calls, performance reviews, and renewal value conversations.
• Advocate for sound actuarial practices, methodologies, and processes.
• Provide strategic guidance on healthcare economics, financial outcomes, pricing, and market opportunities.
• Lead health economic studies, cost savings analyses, and outcomes research.
• Leverage medical and pharmacy claims datasets to evaluate utilization, adherence, and costs.
• Develop and maintain performance guarantee offerings and oversee reserve requirements.
• Develop risk-based pricing approaches and support value-based contracting.
• Present actuarial and health economic findings to customers, consultants, payers, and industry audiences.
• Serve as the primary actuarial contact for independent cost savings studies and research collaborations.

Required qualifications

• 7+ years of actuarial experience within healthcare, health insurance, or a related healthcare organization.
• Experience conducting health economic and financial analyses.
• Client-facing or sales-support experience.
• Deep knowledge of actuarial principles, healthcare economics, risk assessment, and statistical methodologies.
• Proficiency in R.
• Experience analyzing large medical and pharmacy claims datasets.
• Ability to leverage artificial intelligence tools and agents.
• 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.
• Willingness to travel up to 20% of the time.

About the company

Hello Heart is an AI company focused on heart health that builds a platform to predict and prevent cardiac events. It serves large U.S. health plans and hundreds of public and private employers.