Tuesday Health Logo

Tuesday Health

Director Actuarial Services

Posted An Hour Ago
Be an Early Applicant
Remote
Hiring Remotely in United States
Expert/Leader
Remote
Hiring Remotely in United States
Expert/Leader
Leads actuarial services for value-based healthcare contracts, including customer settlements, underwriting, pricing, risk assessment, contract negotiations, claims reporting, and cost-trend analysis. Maintains actuarial soundness for financial projections and risk arrangements, partners with data, finance, medical economics, and growth teams, represents the organization with payer actuaries, and builds actuarial and analytical capabilities.
The summary above was generated by AI

About Tuesday Health


Tuesday Health is a value-based palliative care provider dedicated to transforming serious illness and end-of-life care. We deliver goal-centered care focused on alleviating physical symptoms and emotional stress for individuals and their caregivers. Our interdisciplinary care teams reduce avoidable hospitalizations and improve quality of life wherever individuals call home. Through our leading-edge care model, Tuesday Health is shaping the future of community-based palliative care nationwide.

The Role

The Director, Actuarial Services leads the actuarial function supporting Tuesday Health's value-based contracts with health plan and payer partners. This role owns the quantitative foundation of Tuesday Health's risk-bearing arrangements: calculating customer settlements, supporting contract negotiations with sound actuarial analysis, pricing and underwriting new and renewing contracts, and producing the claims-based reporting and trend analysis that inform both external partner discussions and internal clinical and operational strategy. This role requires actuarial expertise specifically grounded in value-based care and alternative payment models, applied to a serious-illness and palliative care population with distinctive utilization and cost patterns.

The Director will work closely with Tuesday Health's Data & Analytics, Finance, and Growth teams, and will represent Tuesday Health directly to payer-side actuarial and analytics counterparts.

Key Responsibilities

      Lead customer settlement calculations for value-based contracts, including reconciliation of actual performance against contractual targets (e.g., shared savings, shared risk, or total cost of care benchmarks), ensuring calculations are accurate, defensible, and clearly documented for both internal and external stakeholders.

      Support contract negotiations with health plan and payer partners by developing and presenting actuarial analyses of proposed terms, risk arrangements, benchmarks, and financial projections, and by advising .

      Own underwriting for new and renewing contracts, including pricing analysis, risk assessment of new populations and markets, and development of actuarially sound assumptions for program growth and expansion.

      Produce claims-based reporting covering cost, utilization, and quality metrics for internal leadership and external customers, ensuring reporting methodology is consistent, transparent, and aligned with contractual definitions.

      Lead deep-dive analyses of claims trends, identifying drivers of cost and utilization (e.g., hospitalization, emergency department use, post-acute care) and translating findings into actionable input for clinical, operational, and growth strategy.

      Maintain actuarial soundness of financial projections, reserves, and risk assessments related to Tuesday Health's value-based and risk-bearing arrangements, consistent with applicable Actuarial Standards of Practice (ASOPs).

      Partner with Data & Analytics and Medical Economics to ensure claims and utilization data used in actuarial work is complete, accurate, and appropriately sourced from Tuesday Health's data infrastructure.

      Represent Tuesday Health in technical discussions with payer-side actuaries and analytics teams, building credibility and trust in Tuesday Health's methodology and results.

      Build and mentor actuarial and analytical capability as the function grows, establishing repeatable methodology and documentation for recurring actuarial processes (settlements, underwriting, trend reporting).

      Other duties may be assigned.

A Strong Candidate Will Demonstrate

Required Qualifications

      Substantial actuarial experience in value-based care, alternative payment models, or other risk-bearing healthcare arrangements (e.g., ACOs, Medicare Advantage risk arrangements, shared savings/shared risk programs, capitation).

      Hands-on experience with claims-based underwriting, pricing, and risk assessment for provider organizations, payers, or risk-bearing entities.

      Experience leading or directly performing settlement calculations and financial reconciliations under value-based contracts.

      Experience supporting payer contract negotiations with actuarial and financial analysis.

      Strong claims data analysis skills, including experience identifying and explaining cost and utilization trends.

      Bachelor's degree in actuarial science, mathematics, statistics, economics, or a related quantitative field.

      Strong written and verbal communication skills, including the ability to explain actuarial findings to non-actuarial audiences, both internal and customer-facing.

Preferred Qualifications

      Fellow (FSA) or Associate (ASA) of the Society of Actuaries,; Member of the American Academy of Actuaries (MAAA).

      Experience in complex/high-acuity value-based populations.

      Experience with CMS alternative payment models (e.g., ACO REACH, Medicare Shared Savings Program) or Medicare Advantage risk-adjustment methodologies (e.g., HCC models).

      Experience working directly with SQL or similar tools to query and analyze large claims datasets.

      Experience managing or mentoring actuarial or analytical staff.

Alignment with Tuesday Health's Core Values

      We put members first.

      We lead with integrity.

      We pursue different perspectives.

      We are open, curious, and human.

      We deliver.

What We Offer

      Competitive compensation, reflecting our commitment to attracting, retaining, and motivating the best talent in the industry.

      Comprehensive benefits including medical, dental, vision, and life insurance, paid time off and holidays, employer 401(k) match, etc.

      Remote work with multiple onsite sessions each year to maximize collaboration and team building.

      A dynamic and inclusive team environment where you can lean on your teammates, offer candid feedback, bring your true self to work each day, and deliver tremendous impact while having fun along the way.

      Meaningful work each day; we care deeply about our mission, our patients, and each other.

If you are passionate about improving the quality of care for seriously ill individuals and their caregivers through innovative solutions, we would love to hear from you. Please apply by sending your resume and cover letter to [email protected].

Tuesday Health seeks to recruit and retain staff from diverse backgrounds and encourages qualified candidates to apply. Tuesday Health is an equal opportunity employer and does not discriminate on the basis of age, sex, gender identity/expression, sexual orientation, color, race, creed, national origin, ancestry, religion, marital status, political belief, physical or mental disability, pregnancy, military, or veteran status.

Similar Jobs

24 Days Ago
In-Office or Remote
135K-231K Annually
Senior level
135K-231K Annually
Senior level
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
Lead actuarial analytics and Medicare Supplement rate filing processes, build and validate pricing models, engage regulators, provide performance insights, monitor market and regulatory changes, and collaborate cross-functionally to influence strategy.
Top Skills: AccessClaudeCopilotExcelPower PivotSASSQL
23 Hours Ago
In-Office or Remote
113K-193K Annually
Senior level
113K-193K Annually
Senior level
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
Lead actuarial analytics and pricing for Medicare Advantage bids, perform data analysis, actuarial modeling, and forecasting. Develop pricing methodologies, evaluate utilization and cost studies, prepare CMS submissions, and support decision-making through quantitative analysis and cross-functional project leadership.
Top Skills: ChatgptClaudeLarge Language ModelsExcelSASSQL
8 Days Ago
In-Office or Remote
135K-200K Annually
Senior level
135K-200K Annually
Senior level
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
Lead and grow an actuarial team to build and oversee models for Medicare Advantage, Commercial, and Medicaid value-based arrangements. Analyze large claims and cost data, recommend actuarially sound financial terms, support contract negotiations, communicate insights to stakeholders, and drive strategic initiatives and process improvements.
Top Skills: ExcelSQL

What you need to know about the Austin Tech Scene

Austin has a diverse and thriving tech ecosystem thanks to home-grown companies like Dell and major campuses for IBM, AMD and Apple. The state’s flagship university, the University of Texas at Austin, is known for its engineering school, and the city is known for its annual South by Southwest tech and media conference. Austin’s tech scene spans many verticals, but it’s particularly known for hardware, including semiconductors, as well as AI, biotechnology and cloud computing. And its food and music scene, low taxes and favorable climate has made the city a destination for tech workers from across the country.

Key Facts About Austin Tech

  • Number of Tech Workers: 180,500; 13.7% of overall workforce (2024 CompTIA survey)
  • Major Tech Employers: Dell, IBM, AMD, Apple, Alphabet
  • Key Industries: Artificial intelligence, hardware, cloud computing, software, healthtech
  • Funding Landscape: $4.5 billion in VC funding in 2024 (Pitchbook)
  • Notable Investors: Live Oak Ventures, Austin Ventures, Hinge Capital, Gigafund, KdT Ventures, Next Coast Ventures, Silverton Partners
  • Research Centers and Universities: University of Texas, Southwestern University, Texas State University, Center for Complex Quantum Systems, Oden Institute for Computational Engineering and Sciences, Texas Advanced Computing Center

Sign up now Access later

Create Free Account

Please log in or sign up to report this job.

Create Free Account