Senior Actuary

Hippocratic AI • Palo Alto, CA

10d • Onsite

About The Position

Hippocratic AI is looking for a Senior Actuary to join our G&A team, reporting to the Chief Business Development Officer. This role is central to how we engage with payor partners — you’ll build the actuarial models, risk analyses, and economic frameworks that demonstrate the clinical and financial value of our AI platform to health plans and managed care organizations.
You’ll work at the intersection of healthcare economics, data science, and business strategy — translating complex claims and utilization data into insights that shape how Hippocratic AI prices, contracts, and proves ROI for payor customers. This is a high-impact, foundational role in a fast-moving company where your work will directly influence our go-to-market strategy with health plans.

Requirements

• Bachelor’s degree in Actuarial Science, Mathematics, Statistics, or a related quantitative discipline from an accredited institution
• Fellow of the Society of Actuaries (FSA) designation.
• 10+ years of actuarial experience in health insurance, managed care, or healthcare consulting.
• Deep expertise in medical/pharmacy claims analysis, rate development, reserving, or risk adjustment (e.g., HCC models).
• Advanced proficiency in SQL, Python, R, or actuarial modeling tools (e.g., GGY AXIS, MG-ALFA, or similar).
• Experience building financial models for value-based care, capitation, or performance-based contracting.
• Strong communication skills — ability to translate actuarial concepts for non-technical stakeholders, including business development and executive leadership.
• Commitment to safety, ethics, and patient-centered outcomes.
• Intellectual curiosity and mission alignment.

Nice To Haves

• Experience in Medicare Advantage, Medicaid managed care, or ACA marketplace actuarial work.
• Exposure to healthcare AI, digital health, or health technology companies.
• Experience at a startup or high-growth company where you wore multiple hats.
• Familiarity with CMS risk adjustment methodologies and HEDIS/quality metrics.

Responsibilities

• Build and maintain actuarial models to quantify the clinical and financial impact of Hippocratic AI’s platform for payor partners, including projected cost savings, utilization changes, and return on investment.
• Develop pricing frameworks and risk-sharing models for payor contracts, including value-based, capitated, and performance-guarantee arrangements.
• Analyze medical and pharmacy claims data, utilization trends, and population health metrics to support business development conversations and contract negotiations.
• Create financial projections and scenario analyses that inform go-to-market strategy for Medicare Advantage, Medicaid managed care, and commercial payor segments.
• Partner closely with Business Development, Product, Clinical, and Finance teams to translate actuarial insights into compelling payor-facing materials, proposals, and case studies.
• Monitor post-implementation outcomes and perform experience studies to validate model assumptions and demonstrate ongoing value to payor customers.
• Stay current on healthcare regulatory changes, reimbursement trends, and industry benchmarks that affect payor economics and contract structures.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level