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Pomelo Care

Pomelo Care

Accounting & Finance
United States
Posted on Tuesday, April 30, 2024

About us

Pomelo Care is a multi-disciplinary team of clinicians, engineers and problem solvers who are passionate about improving care for moms and babies. We are transforming outcomes for pregnant people and babies with evidence-based pregnancy and newborn care at scale. Our technology-driven care platform enables us to engage patients early, conduct individualized risk assessments for poor pregnancy outcomes, and deliver coordinated, personalized virtual care throughout pregnancy, NICU stays, and the first postpartum year. We measure ourselves by reductions in preterm births, NICU admissions, c-sections and maternal mortality; we improve outcomes and reduce healthcare spend.

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.

Our salary ranges are based on paying competitively for our company’s size and industry, and are one part of the total compensation package that also includes equity, benefits, and other opportunities at Pomelo Care. In accordance with New York City, Colorado, California, and other applicable laws, Pomelo Care is required to provide a reasonable estimate of the compensation range for this role. Individual pay decisions are ultimately based on a number of factors, including qualifications for the role, experience level, skillset, geography, and balancing internal equity. Given that this role is open to candidates of different skill levels, determining a salary range is challenging. A reasonable estimate of the current salary range is $145,000 to $175,000. We expect most candidates to fall in the middle of the range. We also believe that your personal needs and preferences should be taken into consideration, so we allow some choice between equity and cash.