Actuarial Analyst, Experienced

Your Role

The Pay for Value team supports the program design, budget setting, and operations of Blue Shield of California’s value-based care (VBC) payment models, including Accountable Care Organization (ACO), Virtual Care, and other innovative incentive programs. The Actuarial Analyst, Experienced will report to the Actuarial Manager of the Pay for Value team. In this role you will support reporting and analytical work across various programs, collaborating with colleagues from diverse backgrounds and roles within the company.

Your Work

In this role, you will:

• Understand the core principles and functionality of decision, descriptive, predictive and prescriptive analytic methods including forecasting, statistical and machine learning techniques
• Conduct and develop analysis, assess risk and population risk scores and assignment, develop pricing and trends, assess changes in benefit designs, develop reserves, perform forecasting, analyze provider reimbursement terms and/or evaluates actuarial risk related analysis
• Coordinate, prepare, perform and audit actuarial analyses to assist in the development of complex actuarial formulations leading to the recommendation of pricing, trending, reserving, provider reimbursement and/or risk assessment strategies
• Perform data exploration using a combination of statistical programming languages (including, but not limited R, Python, SQL, SAS) and deploy predictive analytics and machine learning techniques to improve risk prediction, improve reserve, trend and financial forecasting in a manner that is actuarially sound, and enable real-time results and operational efficiencies
• Direct, coordinate, and/or develop evaluation and financial reporting standards for internal and external reports

• Support program reporting and analytics, including cost target setting, reconciliation, forecasting, and "what-if" modeling to inform strategy development

• Collaborate with internal teams and cross-functional partners to support program development and ensure alignment with BSC healthcare affordability and quality objectives

• Perform ad-hoc actuarial analyses to support various business needs and provide actionable insights and recommendations based on these analyses

• Understand how other network initiatives and alternate payment models interplay and affect VBC programs and relationships

Your Knowledge and Experience

 

• Requires a bachelor’s degree with at least a minor in mathematics, statistics, computer science or equivalent business experience

• Requires at least 2 years of professional actuarial experience

• Typically, has completed 3 courses towards the eventual attainment of the Associate, Society of Actuaries (ASA) designation.

• Requires advanced experience and skillset in Microsoft Excel and/or SAS/SQL

• Requires strong communication and presentation skills

• Experience with data visualization tools such as Power BI or Tableau preferred

• Prior healthcare industry experience preferred

   

Hybrid 

This role requires employees to be in-office based on our hybrid workplace model, balancing purposeful in-person collaboration with flexibility. For most teams, this means coming into the office two days each week.

Employees living more than 50 miles from an office location will work with their manager to determine in-office time based on business need.