Actuarial Analyst II

Horizon Blue Cross Blue Shield of New Jersey•Hopewell, NJ

16h•Onsite

About The Position

This mid-level analyst role performs actuarial analysis for Horizon’s Medicaid business, including reserving and valuation, forecasting, experience analysis, and rate advocacy. This role applies actuarial techniques and data analysis to evaluate medical cost trends, utilization, program performance, while collaborating with actuarial leadership and cross functional partners.

Requirements

Bachelor’s degree in Actuarial Science, Mathematics, Statistics, Economics, or a related field.
2–4 years of actuarial or analytical experience.
Medicaid, or other government programs health insurance preferred.
Strong analytical, problem‑solving, quantitative skills, and written and verbal communication skills.
Proficiency in Excel and exposure to actuarial or data tools (e.g., SQL, SAS, R, Python, or similar.)
Working towards an ASA is highly preferred.
Associate of the Society of Actuaries (ASA) preferred.
Familiarity with capitation rate development and regulatory filings highly preferred.
Overachieving – demonstrated through a commitment to execution, accountability, results, and a curiosity mindset.
Requires expert knowledge of Excel.
Requires advanced proficiency with SAS or SQL.
Analytical thinking and attention to detail
Developing actuarial judgment
Ability to manage multiple priorities and deadlines
Collaboration and effective communication
Commitment to continuous learning and professional growth

Responsibilities

Support forecast development and financial projections, reserves and analytics for the Medicaid lines of business.
Assess the impact of proposed state and federal legislative changes.
Perform experience analysis for Medicaid products, including medical cost, utilization, and trend components.
Monitor emerging experience and identify drivers of variance from expected results.
Prepare actuarial exhibits, summaries, and documentation for internal leadership and external stakeholders.
Provide support for additional actuarial projects as requested.
Assist with Medicaid quarterly financial reporting, certifications, and responses to state inquiries.
Support analysis related to benefit changes, policy updates, and regulatory requirements.
Evaluate the financial impact of program changes, quality initiatives, and value‑based arrangements.
Ensure analyses align with CMS and state Medicaid guidelines.
Develop, maintain, and enhance actuarial models used for Medicaid analysis.
Validate data sources and ensure accuracy, consistency, and reasonableness of results.
Apply actuarial judgment in selecting assumptions and methodologies under guidance from senior staff.
Partner with Finance, Network, Clinical, and Operations teams to support Medicaid initiatives.
Communicate analytical results clearly to non‑actuarial stakeholders.
Respond to ad-hoc data requests and analytic questions related to Medicaid performance.