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Senior Actuarial Analyst
2 months ago
The Actuarial Provider Strategies team is instrumental in crafting and executing value-based care (VBC) payment frameworks, which encompass Accountable Care Organizations (ACOs) and other pioneering alternative payment structures aimed at enhancing the affordability and quality of care for our members.
The Senior Actuarial Analyst will report directly to the Senior Manager of Actuarial Provider Strategies, collaborating closely with team members and colleagues from diverse professional backgrounds within the organization.
Your ResponsibilitiesIn this position, you will:
- Grasp the fundamental principles and functionalities of decision-making, descriptive, predictive, and prescriptive analytical methodologies, including forecasting, statistical analysis, and machine learning techniques.
- Conduct comprehensive analyses, evaluate risk and population risk scores, develop pricing models and trends, assess modifications in benefit designs, establish reserves, perform forecasting, analyze provider reimbursement agreements, and evaluate actuarial risk-related analyses.
- Coordinate, prepare, execute, and audit actuarial evaluations to support the formulation of complex actuarial models leading to recommendations on pricing, trending, reserving, provider reimbursement, and/or risk assessment strategies.
- Engage in data exploration utilizing a mix of statistical programming languages (including, but not limited to R, Python, SQL, SAS) and implement predictive analytics and machine learning techniques to enhance risk prediction, improve reserves, and financial forecasting in a manner that is actuarially sound, facilitating real-time results and operational efficiencies.
- Direct, coordinate, and/or develop evaluation and financial reporting standards for both internal and external reports.
- Contribute to the development of innovative value-based care (VBC) designs and strategies.
- Provide financial modeling, forecasting, and analytical support for VBC initiatives.
- Assist in the creation of dashboards, scorecards, and other reporting tools using data visualization platforms such as Excel, Tableau, and/or Power BI.
- Research clinical and financial outcomes from other VBC initiatives within the healthcare sector.
- Present financial materials to key stakeholders and leadership, including Network, Payment Innovation, Clinical, and Actuarial partners.
Requires a bachelor's degree with at least a minor in mathematics, statistics, computer science, or equivalent business experience.
Requires a minimum of 2 years of professional actuarial experience.
Requires prior experience in the healthcare industry.
Requires advanced proficiency in Microsoft Excel and SAS/SQL.
Requires strong communication, presentation, and creative problem-solving skills.
Requires proficiency in data visualization tools such as Tableau and/or Power BI preferred.
Requires excellent organizational and project management capabilities.
Compensation Range:
The compensation range for this role is: $ to $ for California.
Note:
This range represents the compensation for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are determined based on various factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.
