Actuarial Analyst, Consultant

Blue Shield of California • El Dorado Hills, CA

4d • $123,090 - $251,720 • Hybrid

About The Position

The Actuarial Analyst serves as a lead actuarial subject matter expert responsible for shaping enterprise payment and value-based care strategies, developing new program concepts, evaluating financial impact, and translating innovative ideas into scalable solutions that improve affordability, quality, provider performance, and member outcomes. You will partner cross-functionally with business, clinical, operational, technology, finance, and provider stakeholders to guide complex workstreams from concept through implementation, influence recommendations, navigate ambiguity, and provide direction and review for junior team members. Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Requirements

• Requires a bachelor’s degree with at least a minor in mathematics, statistics, computer science or equivalent business experience
• Requires at least 6 years of professional actuarial experience
• Required experience in healthcare actuarial analytics, provider reimbursement, value-based care, pricing, forecasting, reserving, risk adjustment, provider contracting, or related financial modeling
• Required advanced proficiency in Excel and analytical programming languages such as SQL, Python, and SAS, with demonstrated experience developing financial models, forecasting methodologies, pricing and savings analyses, analytical frameworks, automation solutions, and decision-support tools
• Required ability to independently develop multiple potential solutions to complex and ambiguous business problems, formulate recommendations with supporting rationale, influence decisions without direct authority, and manage large cross-functional projects or processes
• Required ability to communicate complex actuarial findings and strategic recommendations to technical and non-technical audiences, including leadership and cross-functional stakeholders

Nice To Haves

• Masters in applied mathematics, actuarial science, statistics, or finance preferred
• ASA (Associate of the Society of Actuaries) and/or FSA (Fellow of the Society of Actuaries) highly preferred
• Desired experience guiding, mentoring, delegating work to, and reviewing work products for junior actuarial analysts or other quantitative professionals
• Desired experience with Tableau, Power BI, data visualization technologies, dashboard development, reporting automation, executive reporting solutions, and visually compelling decision-support tools

Responsibilities

• 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 evaluate 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 analytical programming languages including Python, SQL, and SAS, and deploy predictive analytics and machine learning techniques to improve forecasting, financial modeling, risk prediction, and operational efficiencies
• Direct, coordinate, and/or develop evaluation and financial reporting standards for internal and external reports
• Lead the development of new programs, provider payment strategies, and analytical frameworks that advance affordability, quality, provider performance, and member outcomes.
• Evaluate and shape strategic initiatives through financial modeling, ROI analyses, savings assessments, forecasting methodologies, vendor evaluations, and program design recommendations that support investment and implementation decisions.
• Lead cross-functional collaboration across business, clinical, operational, technology, finance, and provider stakeholders to translate strategic concepts into actionable plans, build alignment, navigate ambiguity, resolve issues, and move initiatives from ideation through execution
• Develop innovative, visually compelling, and professionally designed analytical tools, dashboards, forecasting models, and executive reporting packages that transform complex data into actionable insights and support decision-making

Benefits

• Pay Range for CA: $123,090.00 to $184,800.00
• Pay Range for Bay Area: $138,756.00 to $208,320.00
• Note: Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield Salaries are based on a variety of factors including the candidate experience, location (California, Bay Area, or outside California), and current employee salaries for similar roles.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level