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Actuarial Analyst, Senior
2 months ago
The Actuarial Provider Strategies team at Blue Shield of California is seeking a highly skilled Senior Actuarial Analyst to support the design and analytical operations of our value-based strategy. As a key member of this team, you will report to the Principal Analyst on Actuarial Provider Strategies and play a critical role in driving business growth and innovation.
Key Responsibilities- Support analytical work for the Accountable Care Organization (ACO) incentive program, network configuration, and other innovative, alternative payment models.
- 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, but not limited to 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.
- Bachelor's degree with a minor in mathematics, statistics, computer science, or equivalent business experience.
- At least 3 years of professional actuarial experience.
- ASA or majority of the courses completed for the ASA.
- Advanced experience and skillset in Microsoft Excel and/or SAS/SQL.
- Strong communication and presentation skills.
- Curious mindset and eagerness to learn.
- 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.
