Actuarial Strategist

The Actuarial Provider Strategies team at Blue Shield of California supports the design and analytical operations of our value-based strategy. As an Actuarial Analyst - Senior, you will report to the Principal Analyst on Actuarial Provider Strategies and work closely with colleagues from various backgrounds and roles within the company.

• Understand the core principles and functionality of decision, descriptive, predictive, and prescriptive analytic methods, including forecasting, statistical, and machine learning techniques.
• Conduct and develop complex analysis, assess risk, and population risk scores and assignment, perform forecasting, analyze provider reimbursement terms, and/or evaluate 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 provider reimbursement and/or risk assessment strategies.
• Perform data exploration using a combination of statistical programming languages (including R, Python, SQL, SAS) and deploy predictive analytics and machine learning techniques to improve risk prediction and related financial forecasting in a manner that is actuarially sound and enables real-time results and operational efficiencies.
• Direct, coordinate, and/or develop evaluation and financial reporting standards for internal and external reports.
• Support network design work to drive cost of healthcare savings, including building value-based provider reimbursement strategies.
• Provide financial impacts to key business partners to support decision-making on network composition and contracting terms.
• Support ACO incentive program analytical work, such as target setting, reconciliation, supporting provider inquiries, and "what-if" modeling for strategy development.
• Work cross-functionally to respond to provider inquiries while connecting to larger enterprise strategies and needs, including analytics to address questions. Understand how other network initiatives and alternate payment models interplay and affect ACO programs and relationships.
• Work with other colleagues from different areas to solve business problems; this may involve presenting verbally or in written format to key stakeholders or leadership.

• Requires a bachelor's degree with at least a minor in mathematics, statistics, computer science, or equivalent business experience.
• Requires at least 3 years of professional actuarial experience.
• Requires an ASA or majority of the courses completed for the ASA.
• Requires advanced experience and skillset in Microsoft Excel and/or SAS/SQL.
• Requires strong communication and presentation skills.
• Requires a curious mindset and eagerness to learn.
• Requires experience in visualization tools like Tableau and machine learning basics.
• Prior healthcare industry experience preferred.

The pay range for this role is: $ to $ for California.

Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.