Blue Shield of California

Actuarial Analyst, Senior

Blue Shield of California  •  Oakland, CA (Remote)  •  11 hours ago
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Job Description

Your Role

The Network & Trend Analytics (NTA) team provides analytical and strategic support for BSC provider contract negotiations and performance management in collaboration with other departments. Our work is essential for us to fulfill our mission. The Actuarial Analyst, Senior will report to the Actuarial Analyst, Principal. In this role you will develop actuarial models to support contract negotiations, perform benchmarking studies, work on presentations for strategic meetings for senior executives as well as meet other business needs.

Your Work

In this role, you will:

  • Understand the core principles and functionality of decision, descriptive and predictive 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 deploys 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
  • Develop evaluation and financial reporting standards for internal and external reports
  • Develop presentations for senior-executive strategic meetings by working with different teams, including performing various actuarial studies using different tools (Excel, SAS, SQL, etc.)

  • Conduct benchmarking, BSC health care spend, price transparency and competitive studies leveraging internal and external data sources

  • Be able to work under a fast-paced organization

Your Knowledge and Experience

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

  • Requires a minimum of 3 years of professional actuarial experience

  • Requires an ASA designation or has completed the majority of the courses to complete the ASA designation

  • Requires proficiency with MS Office, including Excel, Word, PowerPoint

  • Preferred: work experience with SQL or SAS and large health care databases

  • Preferred: project management work experience

  • Preferred: work experience with provider contracting analytics

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.

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Blue Shield of California

About Blue Shield of California

Blue Shield of California strives to create a healthcare system worthy of its family and friends that is sustainably affordable. The health plan is a tax paying, nonprofit, independent member of the Blue Shield Association with nearly 6 million members, over 7,500 employees and more than $25 billion in annual revenue.

Founded in 1939 in San Francisco and now headquartered in Oakland, Blue Shield of California and its affiliates provide health, dental, vision, Medicaid and Medicare healthcare service plans in California. The company has contributed more than $60 million to Blue Shield of California Foundation in the last three years to have an impact on California communities.

For more news about Blue Shield of California, please visit news.blueshieldca.com.

Industry
Finance & Insurance
Company Size
5,001-10,000 employees
Headquarters
Oakland, California
Year Founded
1939
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