Actuarial Analyst, Senior

Your Role 

The Actuarial Provider Strategies team supports the budget setting, program design, and operations of Blue Shield of California’s value-based care (VBC) payment models, which includes Accountable Care Organization (ACO) and other innovative, alternative payment models. The Actuarial Analyst - Senior will report to the Principal of Actuarial Provider Strategies. In this role you will have responsibility evaluating the performance of Blue Shield of California’s value-based care models, including cost, utilization and quality assessment.

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 

• Support the evaluation studies, from planning, alignment with stakeholders, data gathering, analysis, review, communication, to write-up. 

• Perform data exploration using a combination of statistical programming languages (including, but not limited, R, Python, SQL, SAS) and deploy actuarial and statistical techniques to evaluate the value-based care models with clear outcome and deliverable

• Direct, coordinate, and/or develop evaluation and financial reporting standards for internal and external reports 

• Support production of the final evaluation deliverables encompassing cost, utilization and quality assessment and synthesize the results for general audience’s understanding for all of Blue Shield of California’s value-based care models. This can be done via presentations, memos, external publications, or all the above.

• Research clinical and financial outcomes from others like value-based care programs in the industry 

• Work with other colleagues from different areas to solve business problems; this may involve presenting either verbally or in written format to key stakeholders or leadership

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 3 years of professional actuarial experience 
• Requires advanced experience and skillset in Microsoft Excel and/or SAS/SQL 
• Requires strong communication and presentation skills
• Requires strong ability to communicate complex technical subjects to non-technical audiences 
• Desires some level of experience in Visualization tool like Tableau and Machine Learning basics 
• Desires a curious mindset and eagerness to learn 
• Prior healthcare industry experience preferred