Role Description

Your North Star: drive our risk process end-to-end, from contracting (e.g., model design and strategic negotiations with payers) through to execution (e.g., tracking ongoing performance and identifying issues)

As the first Actuary at Pomelo, you will play a pivotal role in shaping our financial strategy and understanding our impact on payers. You will drive negotiations with large payers’ actuarial teams while helping Pomelo understand its risk, and tracking against risk contracts. You will identify areas of concern and work closely with our data science team to understand the causes, enabling our operational teams to develop effective solutions. Specifically you will:

• Analyze financial costs and trends to guide strategic decisions.
• Lead negotiations and reconciliations with payer teams.
• Develop and maintain actuarial models for risk assessment and financial forecasting.
• Collaborate with the data science team to understand areas of potential risk and to develop innovative solutions.
• Participate in the negotiation process with large payer actuarial teams.
• Provide actuarial insights to support the development of risk contracts.
• Identify opportunities for improved financial performance through actuarial analysis.

Who you are

• Bachelor's degree; FSA strongly preferred.
• 5 years experience as a healthcare actuary.
• Extensive knowledge of concepts and methodologies in Medicaid, Value Based Care, and Provider Contracting.
• Excellent analytical skills with an independent viewpoint.
• Proficient in Microsoft Office Suite products including Word, Excel, PowerPoint, and Outlook.
• Strong software skills in SQL, R, or Python preferred.
• Demonstrated experience fostering collaboration across teams and with clients and key partners.
• Thrives in ambiguity with a bias towards action.

Why you should join our team

By joining Pomelo, you will get in on the ground floor of a fast-moving, well-funded, and mission-driven startup that always puts the patient first. You will learn, grow and be challenged -- and have fun with your team while doing it.

We strive to create an environment where employees from all backgrounds are respected. We also offer:

• Competitive healthcare benefits
• Generous equity compensation
• Unlimited vacation
• Membership in the First Round Network (a curated and confidential community with events, guides, thousands of Q&A questions, and opportunities for 1-1 mentorship)

At Pomelo, we are committed to hiring the best team to improve outcomes for all mothers and babies, regardless of their background. We need diverse perspectives to reflect the diversity of problems we face and the population we serve. We look to hire people from a variety of backgrounds, including but not limited to race, age, sexual orientation, gender identity and expression, national origin, religion, disability, and veteran status.