Actuary – Healthcare Ecosystem
| Company | Hippocratic AI |
|---|---|
| Location | Palo Alto, CA, USA |
| Salary | $Not Provided – $Not Provided |
| Type | Full-Time |
| Degrees | Associate’s |
| Experience Level | Senior |
Requirements
- Associate of the Society of Actuaries (ASA) or Associate of the Casualty Actuarial Society (ACAS); advancement toward Fellowship (FSA/FCAS) strongly preferred.
- 5+ years in healthcare actuarial or health‑economics consulting, preferably within a health system, insurer, or value‑based care organization.
- Proven track record of building robust ROI and cost‑benefit models for clinical programs or population health interventions.
- Advanced proficiency in Excel modeling (including VBA), plus one or more actuarial tools (SAS, R, Python).
- Strong SQL skills and experience with BI platforms for dashboarding and visualization.
- Deep understanding of U.S. healthcare payment models, including fee‑for‑service, bundled payments, shared‑savings ACOs, and capitation. Understanding on the payor side knowledge.
- Familiarity with claims adjudication, risk adjustment methodologies, and utilization management.
- Exceptional analytical rigor and attention to detail.
- Strong verbal and written communication skills; able to translate complex actuarial concepts for non‑technical stakeholders.
- Collaborative mindset and ability to drive cross‑functional initiatives through influence and subject‑matter expertise.
Responsibilities
- Develop, maintain, and validate ROI models for new service lines, care management programs, digital health tools, and community‑health initiatives.
- Quantify cost savings, revenue impacts, utilization trends, and risk adjustments under various scenarios (e.g., bundled payments, ACO, readmission‑reduction programs).
- Extract, cleanse, and aggregate claims, clinical, and financial data from multiple sources (EHR, billing, population‑health platforms).
- Produce dashboards, scorecards, and executive‑level presentations summarizing ROI findings, sensitivity analyses, and break‑even timelines.
- Collaborate with care‑delivery leaders, value‑based contracting teams, and senior executives to define business cases and investment priorities.
- Act as the subject‑matter expert in actuarial assumptions, discount rates, utilization projections, and cost‐benefit frameworks.
- Ensure ROI analyses comply with actuarial standards of practice (ASOPs) and relevant healthcare regulations (e.g., CMS, NCQA).
Preferred Qualifications
- Advancement toward Fellowship (FSA/FCAS) strongly preferred.