Actuarial Analyst III (Government Programs Trend & AI)

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

24d•$87,300 - $119,070

About The Position

This senior-level actuary analyst position is within the Actuarial Department and focuses on trend forecasting for Government Programs, including Medicare, PDP, DSNP, and Medicaid. The role supports evaluation of proposed benefit and cost-sharing changes, pricing studies, analysis of state and federal legislative and regulatory changes, and other actuarial initiatives. It applies actuarial principles, mathematical modeling, and statistical analysis to evaluate risk and support business and pricing decisions. The position also serves as an AI integration partner for actuarial trend work. It helps drive adoption and effective use of AI by identifying trend-development opportunities and key cost and utilization drivers, shaping high-value use cases, delivering small-scale AI solutions, advancing innovation, monitoring adoption outcomes, and escalating misalignment or stalled progress. The role collaborates with internal and cross-functional stakeholders, communicates findings and recommendations to management, and completes additional modeling, forecasting, and analytical projects as needed. Employees must live in New Jersey, New York, Pennsylvania, Connecticut, or Delaware.

Requirements

Bachelor's degree in a quantitative field; a degree in Actuarial Science, Mathematics, Statistics, Economics, Data Science, or a related field is preferred.
At least 4 years of actuarial, statistical, healthcare analytics, or related experience.
Advanced proficiency in Microsoft Excel.
Knowledge of artificial intelligence concepts, tools, and platforms at a practical working level, including generative AI, large language models, prompt engineering, AI assistants, and low-code/no-code AI development tools.
Strong analytical, mathematical, and statistical problem-solving skills.
Excellent verbal and written communication skills, including the ability to present complex information clearly and effectively.
Demonstrated critical thinking, sound judgment, and attention to detail.
Ability to work independently, manage multiple priorities, and meet deadlines in a deadline-driven environment.
Strong mathematical skills and statistical analysis abilities.
Good judgment and problem-solving skills.

Nice To Haves

Progress toward the Associate of the Society of Actuaries (ASA) designation; ASA certification is highly preferred.
Health insurance, healthcare, or managed care experience.
Experience with SAS, SQL, R, Python, or similar analytical or programming tools.
Working knowledge of actuarial concepts, data analysis, and statistical methodologies.

Responsibilities

Assist in the development of forecasted trends.
Evaluate proposed benefit and cost-sharing changes and assess their financial impact.
Conduct pricing analyses and studies for product lines of business.
Analyze the impact of proposed state and federal legislative and regulatory changes.
Conduct experience studies and detailed analyses to identify cost drivers, utilization patterns, and emerging trends.
Identify, shape, and document AI use cases with business unit stakeholders, ensuring opportunities reflect business needs and align with business unit strategy.
Be accountable for AI adoption and utilization within the business unit.
Support additional actuarial projects and initiatives as assigned.
Collaborate with internal stakeholders and incorporate feedback from cross-functional business partners.
Prepare reports and presentations communicating findings, recommendations, and key insights to management.
Complete ad hoc modeling, forecasting, and analytical projects as needed.
Deliver small-scale AI solutions, monitor adoption outcomes, and escalate misalignment or stalled progress.