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Salary: USD 198,400 - 285,200 / annual
Omada Health is seeking a Principal Actuary to build internal actuarial capability and establish how the company measures, communicates, and prices the economic value of its digital health programs. Reporting to the VP of Strategic Finance, this is a hands-on individual contributor role partnering across Finance, Clinical, Commercial, and Strategy teams.
The role combines independent modeling with customer-facing work. You will bring actuarial rigor to savings and ROI methodology, performance guarantees, and at-risk arrangements. Key responsibilities include:
• Partnering with Clinical and Commercial teams to develop ROI models for Medicare and government markets, support Star Ratings analyses, and inform program evaluations.
• Designing and pricing performance guarantees and at-risk terms, building pricing and exposure models, defining measurement triggers, and establishing actuarial guardrails for customer commitments.
• Serving as the actuarial voice in finalist meetings, RFPs, and renewals with payers, employers, and benefits consultants; explaining and defending measurement methodology actuary-to-actuary.
• Modeling and monitoring performance guarantee exposure across the customer portfolio, identifying at-risk contracts and providing accrual and reserve inputs to Accounting.
• Pressure-testing pricing and unit economics, including effects of GLP-1 utilization, pharmacy trend, and medical trend on programs and customers.
• Establishing reusable, version-controlled models and methodology documentation; building actuarial understanding across Finance, Strategy, Commercial, and Clinical; supporting audit and disclosure review.
You will independently set actuarial methodology and assess guarantee soundness while partnering through governance for final pricing, contract terms, material risk acceptance, accounting conclusions, and external claims.
Omada Health is a publicly traded (Nasdaq: OMDA) digital health company reversing how healthcare is delivered in America. The company combines human-led care teams, connected devices, and AI-enabled technology to deliver personalized care at scale for chronic conditions including obesity, diabetes, hypertension, cholesterol, and musculoskeletal conditions. Omada has served over two million members across 2,000+ employers, health plans, PBMs, and health systems.
REQUIREMENTS:
• ASA or FSA designation from the Society of Actuaries, in good standing
• Bachelor's degree in actuarial science, mathematics, statistics, economics, or comparable quantitative field
• 10+ years of healthcare actuarial experience across Medicare Advantage, government markets, payer, consulting, or risk-bearing digital health/provider organizations
• Hands-on experience with medical and pharmacy claims, including building matched-cohort and claims-based savings studies that have withstood third-party scrutiny
• Experience designing or evaluating performance guarantees, shared savings, ROI, or other value-based arrangements, including quantifying downside exposure
• Strong SQL and advanced Excel skills with ability to independently extract data, build models, and validate results
• Strong experience using AI in analytical workflows with clear validation of outputs and appropriate handling of confidential information
• Ability to present and defend methodology to payer actuaries, analysts, benefits consultants, and employer finance leaders
• Intellectual honesty, commercial judgment, and clear written communication
BONUS QUALIFICATIONS:
• FSA and MAAA credentials
• Direct experience with GLP-1 and pharmacy trend economics, including specialty drug management
• Experience in Medicare or government markets (Medicare Advantage, Medicaid managed care, risk adjustment)
• Experience at digital health or point solution vendor selling into employers and payers
• Python or R for modeling and automation, or actuarial consulting background spanning multiple client methodologies
