Consulting Actuary - Medicare Risk Adjustment

Blue Cross and Blue Shield of North Carolina • SC

127d • $117,200 - $222,500

About The Position

As a Consulting Actuary at our healthcare organization, you will play a pivotal role in shaping the future of care delivery through data-driven insights and strategic actuarial expertise. You’ll lead initiatives that directly impact patient outcomes and business performance—whether it’s designing innovative insurance products, optimizing pricing strategies, or evaluating advanced care management models. Your work will support key organizational goals by delivering clear, consistent, and actionable analysis that informs executive decision-making. You’ll also conduct competitive benchmarking and identify emerging risks and opportunities in a rapidly evolving healthcare landscape. This role is ideal for a forward-thinking actuary who thrives in a dynamic environment and is passionate about using their skills to improve healthcare affordability, accessibility, and quality.

Requirements

• Bachelor's degree or advanced degree (where required)
• Member of the American Academy of Actuaries
• Fellow of the Society of Actuaries
• 7 years of relevant actuarial experience, related experience may be considered
• In lieu of an FSA, will consider candidates who are an Associate of the Society of Actuaries (ASA) and have at least 9 years of relevant actuarial experience

Nice To Haves

• Experience in Medicare Advantage Risk Adjustment highly preferred

Responsibilities

• Accountable for completion of complex actuarial or analytical projects, ensuring timeliness, compliance, and quality of work
• Provide proactive and strategic thought leadership of ways to improve processes, reduce risks, and meet department and enterprise objectives to achieve profitable growth and/or improve value, quality, and access for Blue Cross NC customers
• Achieve segment financial targets and provide concise explanations of results and variances to expectations; act as a financial steward for the company
• Communicate effectively with all levels and divisions within the organization, including Divisional Leadership
• Manage external partnerships with vendors, auditors, regulators, and health care providers, including effective negotiation of contracts and/or rates
• Develop and maintain strong business relationships with internal partners through business expertise and exceptional support; act as a strategic advisor
• Meet continuing education standards required for job function, thought leadership and maintenance of actuarial credentials

Benefits

• Medical, dental, and vision coverage along with numerous health and wellness programs
• Parental leave and support plus adoption and surrogacy assistance
• Career development programs and tuition reimbursement for continued education
• 401k match including an annual company contribution
• Work-life balance, flexibility, and the autonomy to do great work

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: Bachelor's degree
• Number of Employees: 5,001-10,000 employees