Actuarial Analyst II

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

3d•$79,100 - $105,945•Remote

About The Position

This role supports actuarial and data analytics for risk-adjusted business across ACA, Medicare Advantage, and Medicaid. Responsibilities include analyzing risk scores, financial impacts, and performance metrics, as well as developing insights to guide risk adjustment strategy, reporting, and pricing/forecasting efforts. The position requires strong analytical skills and the ability to translate data into actionable business recommendations.

Requirements

Bachelors degree is required, preferably within Mathematics, Statistics, Actuarial Sciences or a related field from an accredited college or university.
Requires 2+ years of actuarial and/or statistics experience or attainment of Associate level in the Society of Actuaries (ASA).
Requires working knowledge of Excel.
Requires good oral and written communication skills.
Requires strong analytical thinking.
Requires strong mathematical skill and statistical analysis abilities.
Requires good judgment and problem solving skills.

Nice To Haves

ASA candidate a plus.
Prefers experience with SAS or other programming language.
Prefers knowledge of data analysis and Actuarial principles.

Responsibilities

Perform or support actuarial analytics on risk adjustable lines of business, including ACA, Medicare Advantage, and Medicaid.
Perform or support CMS-HCC and HHS-HCC risk score projections, including RATP, MA MYRA/FYRA accruals, and RADV financial impacts.
Perform or support data analytics and reporting to inform risk adjustment operations, strategy, submissions, and vendor performance.
Perform or support financial metrics pertaining to risk adjustment performance, including but not limited to intervention ROI.
Collect and analyze data to use for financial and utilization reporting and monitoring.
Support pricing and forecast efforts, including ACA pricing and MA Bid submissions.