Senior Actuary

Hippocratic AI Inc.; Palo Alto (CA); On-site; USD 170,000 - 250,000; Full time

Job summary

Hippocratic AI Inc. in Palo Alto seeks a Senior Actuary to join the G&A team, reporting to the Chief Business Development Officer.

This role builds actuarial models, risk analyses, and economic frameworks to demonstrate the clinical and financial value of our AI platform to health plans and managed care organizations. You will translate claims data into insights that shape pricing, contracts, and ROI proofs for payor customers, collaborating across Finance, Product, Clinical, and Business

Qualifications

• Bachelor’s degree in Actuarial Science, Mathematics, Statistics, or a related quantitative discipline.
• FSA designation.
• 10+ years actuarial experience in health insurance, managed care, or healthcare consulting.
• Deep expertise in medical/pharmacy claims analysis, rate development, reserving, or risk adjustment (e.g., HCC models).
• Advanced proficiency in SQL, Python, R, or actuarial modeling tools (e.g., GGY AXIS, MG-ALFA, or similar).
• Experience building financial models for value-based care, capitation, or performance-based contracting.
• Strong communication skills — ability to translate actuarial concepts for non-technical stakeholders, including business development and executive leadership.
• Commitment to safety, ethics, and patient-centered outcomes.
• Intellectual curiosity and mission alignment.

Responsibilities

• Build and maintain actuarial models to quantify the clinical and financial impact of Hippocratic AI’s platform for payor partners, including projected cost savings, utilization changes, and return on investment.
• Develop pricing frameworks and risk-sharing models for payor contracts, including value-based, capitated, and performance-guarantee arrangements.
• Analyze medical and pharmacy claims data, utilization trends, and population health metrics to support business development conversations and contract negotiations.
• Create financial projections and scenario analyses that inform go-to-market strategy for Medicare Advantage, Medicaid managed care, and commercial payor segments.
• Partner closely with Business Development, Product, Clinical, and Finance teams to translate actuarial insights into compelling payor-facing materials, proposals, and case studies.
• Monitor post-implementation outcomes and perform experience studies to validate model assumptions and demonstrate ongoing value to payor customers.
• Stay current on healthcare regulatory changes, reimbursement trends, and industry benchmarks that affect payor economics and contract structures.

Skills

Actuarial modelling

Communication

Healthcare economics

Regulatory awareness

Strategic thinking

Education

Bachelor’s degree in Actuarial Science or related field

Fellow of the Society of Actuaries (FSA)

Tools

SQL

Python

R

GGY AXIS

MG-ALFA

Job description

About Us

Hippocratic AI is the leading generative AI company in healthcare. We have the only system that can have safe, autonomous, clinical conversations with patients. We have trained our own LLMs as part of our Polaris constellation, resulting in a system with over 99.9% accuracy.

Why Join Our Team

Reinvent healthcare with AI that puts safety first. We’re building the world’s first healthcare-only, safety-focused LLM — a breakthrough platform designed to transform patient outcomes at a global scale. This is category creation.

Work with the people shaping the future. Hippocratic AI was co-founded by CEO Munjal Shah and a team of physicians, hospital leaders, AI pioneers, and researchers from institutions like El Camino Health, Johns Hopkins, Washington University in St. Louis, Stanford, Google, Meta, Microsoft, and NVIDIA.

Backed by the world’s leading healthcare and AI investors. We recently raised a $126M Series C at a $3.5B valuation, led by Avenir Growth, bringing total funding to $404M with participation from CapitalG, General Catalyst, a16z, Kleiner Perkins, Premji Invest, UHS, Cincinnati Children’s, WellSpan Health, John Doerr, Rick Klausner, and others.

Build alongside the best in healthcare and AI. Join experts who’ve spent their careers improving care, advancing science, and building world-changing technologies — ensuring our platform is powerful, trusted, and truly transformative.

Location Requirement

We believe the best ideas happen together. To support fast collaboration and a strong team culture, this role is expected to be in our Palo Alto office five days a week.

About the Role

Hippocratic AI is looking for a Senior Actuary to join our G&A team, reporting to the Chief Business Development Officer. This role is central to how we engage with payor partners — you’ll build the actuarial models, risk analyses, and economic frameworks that demonstrate the clinical and financial value of our AI platform to health plans and managed care organizations.

You’ll work at the intersection of healthcare economics, data science, and business strategy — translating complex claims and utilization data into insights that shape how Hippocratic AI prices, contracts, and proves ROI for payor customers. This is a high-impact, foundational role in a fast-moving company where your work will directly influence our go-to-market strategy with health plans.

What You’ll Do

Build and maintain actuarial models to quantify the clinical and financial impact of Hippocratic AI’s platform for payor partners, including projected cost savings, utilization changes, and return on investment.

Develop pricing frameworks and risk-sharing models for payor contracts, including value-based, capitated, and performance-guarantee arrangements.

Analyze medical and pharmacy claims data, utilization trends, and population health metrics to support business development conversations and contract negotiations.

Create financial projections and scenario analyses that inform go-to-market strategy for Medicare Advantage, Medicaid managed care, and commercial payor segments.

Partner closely with Business Development, Product, Clinical, and Finance teams to translate actuarial insights into compelling payor-facing materials, proposals, and case studies.

Monitor post-implementation outcomes and perform experience studies to validate model assumptions and demonstrate ongoing value to payor customers.

Stay current on healthcare regulatory changes, reimbursement trends, and industry benchmarks that affect payor economics and contract structures.

What You Bring

Must-Have:

• Bachelor’s degree in Actuarial Science, Mathematics, Statistics, or a related quantitative discipline from an accredited institution
• Fellow of the Society of Actuaries (FSA) designation.
• 10+ years of actuarial experience in health insurance, managed care, or healthcare consulting.
• Deep expertise in medical/pharmacy claims analysis, rate development, reserving, or risk adjustment (e.g., HCC models).
• Advanced proficiency in SQL, Python, R, or actuarial modeling tools (e.g., GGY AXIS, MG-ALFA, or similar).
• Experience building financial models for value-based care, capitation, or performance-based contracting.
• Strong communication skills — ability to translate actuarial concepts for non-technical stakeholders, including business development and executive leadership.
• Commitment to safety, ethics, and patient-centered outcomes.
• Intellectual curiosity and mission alignment.

Nice-to-Have:

• Experience in Medicare Advantage, Medicaid managed care, or ACA marketplace actuarial work.
• Exposure to healthcare AI, digital health, or health technology companies.
• Experience at a startup or high-growth company where you wore multiple hats.
• Familiarity with CMS risk adjustment methodologies and HEDIS/quality metrics.