Pricing Actuary leading key pricing, modeling, and analytical initiatives at Zenith specializing in Workers’ Compensation. Collaborating with teams to provide actionable recommendations for underwriting and product leadership.
About the role
- Actuary guiding financial strategies for digital musculoskeletal solutions at Hinge Health. Bridging clinical, finance, and sales to optimize ROI frameworks and unlock contracts worth millions.
Responsibilities
- Establish yourself as the go-to actuarial SME for the Commercial team by participating in 3-5 finalist meetings with prospective health plans
- Audit and refine our current Business Case Analysis (BCA) framework to ensure it reflects best-in-class actuarial standards
- Build relationships with key stakeholders across Clinical Research, Finance, Customer Success, and Sales to understand how actuarial insights can accelerate deals
- Lead methodology negotiations with at least two major health plan actuarial teams, securing agreement on ROI validation frameworks that protect Hinge Health's interests while building client trust
- Model financial risk for 'at-risk' contracts, establishing reserves and pricing structures for shared-savings arrangements
- Deliver customized BCAs for high-priority prospects using claims data, Book of Business benchmarks, and external trend data—directly contributing to closing deals worth $5M+ in ARR
- Own the actuarial strategy for Hinge Health's transition to value-based care, designing risk-transfer models and VBC contracting terms that balance growth with financial prudence.
- Standardize our Enhanced Claims Data Analysis (CDA) process, establishing data requirements and analytical frameworks that prove hard-dollar savings to our largest clients
- Create and deliver 'VBC 101' and 'Actuarial Playbook' educational content, upleveling the Commercial and Customer Success teams' ability to speak credibly about financial outcomes
- Represent Hinge Health at industry conferences, positioning the company as a thought leader in digital health economics.
Requirements
- Bachelor's Degree in Actuarial Science
- 8-10+ years of experience in health insurance, specifically with claims data analysis, pricing, and underwriting
- Deep expertise in Medicare Advantage (MA), Fully Insured, and ASO financial models
- Proven ability to translate complex actuarial concepts for non-technical audiences and influence senior stakeholders.
- Fellow of the Society of Actuaries (FSA) and Member of the American Academy of Actuaries (MAAA) preferred.
- Direct experience working with large payer organizations (e.g., Optum, UHG, Anthem, BCBS plans)
- Proficiency in financial modeling (Excel) and data analysis tools; familiarity with healthcare data warehouses (e.g., Databricks) and claims datasets
- Experience with AI tools (e.g., Claude Code) or willingness to develop AI-assisted workflows.
Benefits
- Inclusive healthcare and benefits: help with gender-affirming care, tools for family and fertility planning, and travel reimbursements if healthcare isn't available where you live.
- 401k retirement plan options which include a 2% company match.
- A yearly stipend to invest in your growth.
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