Actuarial Analyst, Experienced

2 weeks ago

Oakland, United States Blue Shield of California Full time

**Your Role
The Actuarial Provider Strategies team helps design and implement value-based care (VBC) payment models, which include Accountable Care Organizations (ACOs) and other innovative alternative payment models (APMs) to improve the affordability and quality of care our members receive. The Experienced Actuarial Analyst will report to the Senior manager of Actuarial Provider Strategies and work closely with their team and with colleagues from various backgrounds and roles within the company.

**Your Work
In this role, you will:

- Understand the core principles and functionality of decision, descriptive, predictive and prescriptive 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 deploy 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
- Direct, coordinate, and/or develop evaluation and financial reporting standards for internal and external reports
- Support the creation of innovative value-based care (VBC) designs and strategies
- Provide financial modeling, forecasting, and analytical support for VBC programs
- Support the development of dashboards, scorecards, and other reporting tools using data visualization tools such as Excel, Tableau, and/or Power BI
- Research clinical and financial outcomes from other VBC programs in the healthcare industry
- Present financial materials to key stakeholders and leadership such as Network, Payment Innovation, Clinical and Actuarial partners

**QUALIFICATIONS
Your Knowledge and Experience
- Requires a bachelor’s degree with at least a minor in mathematics, statistics, computer science or equivalent business experience
- Requires at least 2 years of professional actuarial experience
- Prior healthcare industry experience
- Advanced experience in Microsoft Excel and SAS/SQL
- Strong communication, presentation, and creative problem-solving skills
- Proficiency in data visualization tools such as Tableau and/or Power BI preferred
- Excellent organizational and project management skills

**Pay Range**:
The pay range for this role is: $ 79750.00 to $ 111650.00 for California.

**Note**:
ABOUT THE TEAM
Blue Shield of California’s mission is to ensure all Californians have access to high-quality health care at a sustainably affordable price. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.

To fulfill our mission, we must ensure a diverse, equitable, and inclusive environment where all employees can be their authentic selves and fully contribute to meet the needs of the multifaceted communities we serve. Our continued commitment to diversity, equity, and inclusion upholds our values and advances our goal of creating a healthcare system that is worthy of our family and friends while addressing health disparities, promoting social justice, and integrating health equity through our products, business practices, and presence as a corporate citizen.

Blue Shield has received awards and recognition for being a certified Fortune 100 Best Companies to Work, Military Friendly Employer, People Companies that Care, a Leading Disability Employer, and one of California’s top companies in volunteering and giving. Here at Blue Shield, we strive to make a positive change across our industry and communities - join us

**Our Values**:

- **Honest **. We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short.
- **Human **. We strive to be our authentic selves, listening and communicating effectively, and showing empathy towards others by walking in their shoes.
- **Courageous **. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.

**Our Workplace Model**:
Blue Shield of California is dedicated to making work-life balance a reality. Whether you prefer to work in an office or from home, we understand flexibility is more important than ever. That’s why Blue Shield is a hybrid company, offering you the opportunity to decide where yo

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