Actuary

The Opportunity Imagine being the actuarial voice that turns clinical innovation into undeniable financial value. As Hinge Health scales from a wellness benefit to a medical insurance product with value-based care at its core, you'll be the critical bridge between our Clinical Research, Finance, and Commercial teams—positioning the economic value of our digital MSK solutions in a way that wins over the most skeptical health plan actuaries and secures millions in 'at-risk' contracts. You’ll serve as the primary subject matter expert in high-stakes negotiations with BUCA plans, ACOs, and Integrated Health Systems, defending our ROI methodologies and designing the financial frameworks that enable Hinge Health to participate in shared-risk arrangements—ultimately expanding access to care for millions. What You'll Accomplish In your first 3 months , you will: 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 In your first 6 months , you will: 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 In your first year , you will: 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 (e.g., SOA Health Conference), positioning the company as a thought leader in digital health economics Who You Are A Trust Builder : You communicate complex actuarial concepts with clarity to non-technical stakeholders (Sales, CS, Finance) while commanding peer-level credibility when negotiating with external Chief Actuaries. You embody 'Effective Communication' by making the technical accessible without dumbing it down. A Learn-it-All : You don't just apply established actuarial methods—you're curious about how AI tools (like Claude Code) can transform your work and eager to develop expertise in emerging areas like value-based care contracting. Resilient & Strategic : You thrive in ambiguous, high-stakes environments where you're designing new frameworks (not just applying old ones). You can 'Make Results Happen' even when data is imperfect or client objections seem insurmountable. You think long-term, designing solutions that scale. A Data-Driven Advocate : You let the data tell the story, designing rigorous matched-cohort analyses and claims-based ROI studies that withstand scrutiny. You balance intellectual honesty with business pragmatism, knowing when to push back on unrealistic client demands. Basic 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 Preferred Requirements Fellow of the Society of Actuaries (FSA) and Member of the American Academy of Actuaries (MAAA) 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 What Success Looks Like Win Rate : Directly contributing to securing key 'at-risk' health plan contracts by gaining actuarial buy-in from external teams Methodology Alignment : Successfully negotiating favorable ROI measurement terms that accurately reflect program value without exposing the company to undue risk Strategic Impact : Modeling financial viability for new product lines (e.g., HingeSelect) and influencing the roadmap for value-based care contracting About Hinge Health At Hinge Health, we're using technology to scale and automate the delivery of healthcare – starting with musculoskeletal (MSK) conditions, which affect over 1.7 billion people worldwide. With an AI-powered human-centered care model, Hinge Health leverages cutting-edge technology to improve outcomes, experiences and costs to help people move beyond their pain. The platform addresses a broad spectrum of MSK care – from acute injury, to chronic pain, to post-surgical rehabilitation – through personalized, evidence-based care. As the preferred partner to 50+ health plans, PBMs and other ecosystem partners, Hinge Health is available to over 20 million people across more than 2,550 employers. The company is headquartered in San Francisco with additional offices in Montreal and Bangalore. Learn more at What You'll Love About Us Inclusive healthcare and benefits : On top of comprehensive medical, dental, and vision coverage, we offer employees and their family members help with gender-affirming care, tools for family and fertility planning, and travel reimbursements if healthcare isn't available where you live. Planning for the future : Start saving for the future with our traditional or Roth 401k retirement plan options which include a 2% company match. Modern life stipends : Manage your own learning and development with a yearly stipend to invest in your growth. Culture & Engagement Hinge Health is an equal opportunity employer and prohibits discrimination and harassment of any kind. We make employment decisions without regards to race, color, religion, sex, sexual orientation, gender identity, national origin, age, veteran status, disability status, pregnancy, or any other basis protected by federal, state or local law. We also consider qualified applicants regardless of criminal histories, consistent with legal requirements. We provide reasonable accommodations for candidates with disabilities. If you feel you need assistance or an accommodation due to a disability, let us know by reaching out to your recruiter. By submitting your application you are acknowledging we are using your personal data as outlined in the personnel and candidate privacy policy. Beware of Phishing Attempts: We've noticed an increase in phishing where fraudsters impersonate employees and send fake job offers to steal sensitive information. We'll never ask for financial details during the hiring process and only use '@hingehealth.com' emails. If you receive a suspicious offer, stop communication and report it to the US FBI Internet Crime Complaint Center. To verify an email from our recruiting team, forward it to View email address on click.appcast.io. #J-18808-Ljbffr