Actuarial Analyst, Senior

Blue Shield of California • Oakland, CA

1d

About The Position

Your Role The Pay for Value team supports the program design, budget setting, and operations of Blue Shield of California’s value-based care (VBC) payment models, including Accountable Care Organization (ACO), Virtual Care, and other innovative incentive programs. The Actuarial Analyst, Senior will report to the Actuarial Manager of the Pay for Value team. In this role you will both lead and support reporting and analytical work across various programs, collaborating with colleagues from diverse backgrounds and roles within the company. Responsibilities 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 Lead and support program reporting and analytics, including cost target setting, reconciliation, forecasting, and "what-if" modeling to inform strategy development Collaborate with internal teams and cross-functional partners to support program development and ensure alignment with BSC healthcare affordability and quality objectives Perform ad-hoc actuarial analyses to support various business needs and provide actionable insights and recommendations based on these analyses Understand how other network initiatives and alternate payment models interplay and affect VBC programs and relationships Qualifications Your Knowledge and Experience

Requirements

• Requires a bachelor’s degree with at least a minor in mathematics, statistics, computer science or equivalent business experience
• At least 3 years of professional actuarial experience
• Requires advanced experience with Microsoft Excel and/or SAS/SQL
• Requires strong communication and presentation skills
• Requires attention to detail and ability to manage multiple priorities

Nice To Haves

• Experience with data visualization tools such as Power BI and/or Tableau preferred
• Healthcare industry experience preferred

Responsibilities

• 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
• Lead and support program reporting and analytics, including cost target setting, reconciliation, forecasting, and "what-if" modeling to inform strategy development
• Collaborate with internal teams and cross-functional partners to support program development and ensure alignment with BSC healthcare affordability and quality objectives
• Perform ad-hoc actuarial analyses to support various business needs and provide actionable insights and recommendations based on these analyses
• Understand how other network initiatives and alternate payment models interplay and affect VBC programs and relationships

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees