Associate Actuary, Valuation

at  Pearl Health

WHO WE ARE…

Pearl Health is restoring the independence and joy of practicing medicine for doctors in the United States. Our healthcare system has burdened our doctors with too much process, while removing them from what they do best: caring for those we love most. We are a team of physicians and public health experts (Stanford, Dartmouth, Harvard, Mass. General), technologists (athenahealth, Apple, Amazon, Meta, Flatiron, WalMart Health), healthcare innovators (Oscar, Aledade, VillageMD, Stellar, Arcadia) and experienced risk management professionals (CVS/Aetna, Humana, Cigna, United) who believe that primary care providers (PCPs) are the key to the United States’ future health. Pearl recently announced a strategic partnership to proliferate value-based care with Walgreens, one of the largest healthcare companies in the country. Our investors include Andreessen Horowitz, Viking Global Investors, AlleyCorp, and SV Angel.
Pearl Health helps PCPs who are overwhelmed by the demands of an aging population and the unpredictable business model inherent to Traditional Medicare. Over time, this solution will empower PCPs to provide better care to their entire patient population. We believe there is a need to bring humanism back to healthcare by giving physicians the ability to better allocate their time with patients, increasing their autonomy, creating incentives that are aligned with achieving better outcomes through clinical decision-making powered by actionable intelligence, and making risk more available and more readily optimized through an intelligent marketplace. The Center for Medicare and Medicaid (CMS) is launching a new value-based care program to disrupt Traditional Medicare, and we believe that this represents an opportunity to achieve the meaningful change we envision.

We are seeking a highly skilled Associate Actuary with a history in the Medicare ACO sector, ideally with experience in a startup environment. You will play a central role as the first hire on the Valuation team, and will be tasked with evaluating and reporting the financial risk for Pearl’s current book of business.
You should be a strategic and analytical thinker, an effective communicator, an expert in actuarial reserving techniques in the healthcare space, and comfortable performing sophisticated modeling exercises independently. A familiarity, passion, and willingness to dig into the nuances of different value-based care programs (e.g. ACO REACH, MSSP) and Medicare Advantage will be critical to success.

To be successful in this role you will:

• Maintain and execute upon our Actuarial monthly Valuation cycle in a timely manner, which includes benchmark modeling, setting IBNR and incorporating the latest data from disparate data sources.
• Guide the processes that support shared savings calculations and financial reconciliation for our PCP partners
• Effectively communicate actuarial findings to non-actuarial stakeholders in a manner that is meaningful and provides a clear explanation of valuation results, and potential financial impacts.
• Stay informed about changes in regulations affecting Medicare value-based care programs and adjust actuarial practices accordingly.
• Maintain comprehensive documentation of actuarial work to facilitate regulatory reporting and compliance audits.
• Bolster institutional awareness of our financial performance through cross-functional collaborations with Data Science & Analytics, Finance, Customer Success, ACO Operations, among others.
• Be eligible to participate in Pearl’s Actuarial Student Program.