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Principal Actuary

Work from home Full-time role Hiring

Description About the role We are looking for a hands-on Principal Actuary who can quantify the financial "alpha" created by the intersection of plan design and high-quality care and translate that into product, pricing, and market strategy. We have recently created the Emerging Growth Unit - a new, CEO and board-directed, high-impact business unit, focused exclusively on bringing high impact innovation and next generation solutions to market to drive growth across Quantum and Embold. The first product the Emerging Growth Unit is launching is Embold Edge: the first national quality-driven health plan designed to help employers and health plans reduce healthcare costs by influencing decisions at the most important moment in a member's care journey - choosing a provider. Led by Daniel Stein, the Chief Strategy Officer at Quantum Health and the President of Embold Health, the Emerging Growth Unit is uniquely positioned to harness the combined strengths of Quantum and Embold - including best-in-class provider quality analytics, industry-leading navigation, top-tier member and provider engagement, newly built AI and digital capabilities, and virtual primary care - to create and introduce differentiated solutions that drive meaningful improvements in cost and quality across the industry. We value deep healthcare expertise and a commitment to improving a complex system from within. We also recognize that meaningful change doesn't happen in isolation, so collaboration is core to how we operate - partnering closely with leading employers and health plans to bring new solutions to the market. This is a fast-moving, highly collaborative environment, where ideas quickly become action, and where you will shape strategy, solutions, and outcomes from the ground up. If you are energized by innovation, thrive in fast-paced environments, and want to help drive the organization's future growth while advancing meaningful change across healthcare, we would love to hear from you. Location: This position is located at our Nashville, TN office with hybrid flexibility or may work remotely anywhere in the United States of America. What you'll do (Essential Responsibilities)

  • Architect the Savings Engine: Advance the foundational actuarial models for Embold Edge that link physician quality to tangible medical cost reduction.
  • External Market Authority: Act as the technical face of Embold Edge. You will engage with health plan actuaries, consultants, and other external stakeholders to validate our savings methodology and actuarial assumptions.
  • Reporting Savings: You will work with Client Success and Client Reporting teams to develop quarterly and annual client deliverables and identify key program value levers and opportunities for improvement.
  • Publication: Partner internally and external parties to publish program performance and contribute to the broader dialogue in the actuarial and employee benefits/HR community.
  • Alternative Health Plan (AHP) Strategy: Design innovative financial structures for our health plan partners, including risk-sharing, performance-based pricing, and surplus-sharing models that reward quality.
  • Rapid Prototyping: Work directly with the leadership across organizations to iterate on "next generation" solutions. You must be able to model outcomes for new products that don't have decades of legacy data.
  • All other duties as assigned.

What you'll bring (Qualifications)

  • Credentialed Actuary: ASA or FSA required.
  • Healthcare Modernizer: 7+ years of experience in healthcare actuarial roles. You must understand how traditional plans work so you can articulate exactly why Embold Edge is better.
  • High Stakes Communication: Experience presenting to executive-level audiences (CFOs, CEOs, Board members). You can hold your own in a debate about trend, IBNR, and risk adjustment while staying focused on the growth mission.
  • Collaboration Effectiveness: Demonstrated ability to drive cross-functional work forward in a fast-moving, complex organization through strong judgment, communication, and emotional intelligence.
  • Data Fluency: Mastery of SQL and statistical modeling (Python/R) to extract insights from large-scale claims and provider data sets.
  • Speed & Agility: Experience in a high-growth or "unit-based" environment where speed to market and iterative design are valued over rigid corporate cycles.
  • A high degree of personal accountability and trustworthiness, a commitment to working within Quantum Health's policies, values and ethics, and to protecting the sensitive data entrusted to us.

Preferred Qualifications

  • Experience in healthcare actuarial roles such as pricing, forecasting, product strategy, provider economics, network strategy, value-based care, or consulting.
  • Direct experience with Alternative Health Plans, narrow networks, steerage models, or other innovative health plan structures.
  • Ability to translate actuarial methods into clear, credible narratives for external stakeholders, including clients, consultants, and health plan partners.
  • Interest in improving healthcare quality, affordability, and decision-making through data-driven product innovation.

#LI-AT1 #LI-Onsite #LI-Hybrid #LI-Remote What's in it for you

  • Compensation: Competitive base and incentive compensation
  • Coverage: Health, vision and dental featuring our best-in-class healthcare navigation services, along with life insurance, legal and identity protection, adoption assistance, EAP, Teladoc services and more.
  • Retirement: 401(k) plan with up to 4% employer match and full vesting on day one.
  • Balance: Paid Time Off (PTO), 7 paid holidays, parental leave, volunteer days, paid sabbaticals, and more.
  • Development: Tuition reimbursement up to $5,250 annually, certification/continuing education reimbursement, discounted higher education partnerships, paid trainings and leadership development.
  • Culture: Recognition as a Best Place to Work for 15+ years, dedication to diversity, philanthropy and sustainability, and people-first values that drive every decision.
  • Environment: A modern workplace with a casual dress code, open floor plans, full-service dining, free snacks and drinks, complimentary 24/7 fitness center with group classes, outdoor walking paths, game room, notary and dry-cleaning services and more!

What you should know

  • Internal Associates: Already a Healthcare Warrior? Apply internally through Jobvite.
  • Process: Application > Phone Screen > Online Assessment(s) > Interview(s) > Offer > Background Check.
  • Compensation Ranges: Compensation details published by job boards are estimates and not verified by Quantum Health. Details surrounding compensation will be disclosed throughout the interview process. Compensation offered is based on the candidate's unique combination of experience and qualifications related to the position.
  • Sponsorship: Applicants must be legally authorized to work in the United States on a permanent and ongoing future basis without requiring sponsorship.
  • Agencies: Quantum Health does not accept unsolicited resumes or outreach from third-parties. Absent a signed MSA and request/approval from Talent Acquisition to submit candidates for a specific requisition, we will not approve payment to any third party.

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