Job Description

Your Role

The Actuarial Analyst serves as a lead actuarial subject matter expert responsible for shaping enterprise payment and value-based care strategies, developing new program concepts, evaluating financial impact, and translating innovative ideas into scalable solutions that improve affordability, quality, provider performance, and member outcomes. You will partner cross-functionally with business, clinical, operational, technology, finance, and provider stakeholders to guide complex workstreams from concept through implementation, influence recommendations, navigate ambiguity, and provide direction and review for junior team members.

Responsibilities

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 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 pricing, trending, reserving, provider reimbursement and/or risk assessment strategies
• Perform data exploration using analytical programming languages including Python, SQL, and SAS, and deploy predictive analytics and machine learning techniques to improve forecasting, financial modeling, risk prediction, and operational efficiencies
• Direct, coordinate, and/or develop evaluation and financial reporting standards for internal and external reports
• Lead the development of new programs, provider payment strategies, and analytical frameworks that advance affordability, quality, provider performance, and member outcomes.
• Evaluate and shape strategic initiatives through financial modeling, ROI analyses, savings assessments, forecasting methodologies, vendor evaluations, and program design recommendations that support investment and implementation decisions.
• Lead cross-functional collaboration across business, clinical, operational, technology, finance, and provider stakeholders to translate strategic concepts into actionable plans, build alignment, navigate ambiguity, resolve issues, and move initiatives from ideation through execution
• Develop innovative, visually compelling, and professionally designed analytical tools, dashboards, forecasting models, and executive reporting packages that transform complex data into actionable insights and support decision-making

Future Opportunities

Great talent is always in demand at Blue Shield of California. While there is not a current opening associated with this posting, we are proactively building a network of qualified candidates for future opportunities. We encourage you to apply and stay connected for upcoming roles that align with your skills and interests.

Qualifications

Your Knowledge and Experience

Actuarial Analyst, Consultant

• Requires a bachelor's degree with at least a minor in mathematics, statistics, computer science or equivalent business experience
• Masters in applied mathematics, actuarial science, statistics, or finance preferred
• Requires at least 6 years of professional actuarial experience
• ASA (Associate of the Society of Actuaries) and/or FSA (Fellow of the Society of Actuaries) highly preferred
• Required experience in healthcare actuarial analytics, provider reimbursement, value-based care, pricing, forecasting, reserving, risk adjustment, provider contracting, or related financial modeling
• Required advanced proficiency in Excel and analytical programming languages such as SQL, Python, and SAS, with demonstrated experience developing financial models, forecasting methodologies, pricing and savings analyses, analytical frameworks, automation solutions, and decision-support tools
• Required ability to independently develop multiple potential solutions to complex and ambiguous business problems, formulate recommendations with supporting rationale, influence decisions without direct authority, and manage large cross-functional projects or processes
• Required ability to communicate complex actuarial findings and strategic recommendations to technical and non-technical audiences, including leadership and cross-functional stakeholders
• Desired experience guiding, mentoring, delegating work to, and reviewing work products for junior actuarial analysts or other quantitative professionals
• Desired experience with Tableau, Power BI, data visualization technologies, dashboard development, reporting automation, executive reporting solutions, and visually compelling decision-support tools

Pay Range for CA: $123,090.00 to $184,800.00
Pay Range for Bay Area: $138,756.00 to $208,320.00
Note: 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 experience, location (California, Bay Area, or outside California), and current employee salaries for similar roles.

Actuarial Analyst, Principal

• Requires a bachelor's degree with at least a minor in mathematics, statistics, computer science or equivalent business experience
• Requires at least 10 years of professional actuarial experience including experience in health plan operations and regulatory requirements
• ASA (Associate of the Society of Actuaries) required
• Required experience in healthcare actuarial analytics, provider reimbursement, value-based care, pricing, forecasting, reserving, risk adjustment, provider contracting, or related financial modeling
• Required advanced proficiency in Excel and analytical programming languages such as SQL, Python, and SAS, with demonstrated experience developing financial models, forecasting methodologies, pricing and savings analyses, analytical frameworks, automation solutions, and decision-support tools
• Required ability to independently develop multiple potential solutions to complex and ambiguous business problems, formulate recommendations with supporting rationale, influence decisions without direct authority, and manage large cross-functional projects or processes
• Required ability to communicate complex actuarial findings and strategic recommendations to technical and non-technical audiences, including leadership and cross-functional stakeholders
• Desired experience guiding, mentoring, delegating work to, and reviewing work products for junior actuarial analysts or other quantitative professionals
• Desired experience with Tableau, Power BI, data visualization technologies, dashboard development, reporting automation, executive reporting solutions, and visually compelling decision-support tools

Pay Range for CA: $148,940.00 to $223,300.00
Pay Range for Bay Area: $167,896.00 to $251,720.00
Note: 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 experience, location (California, Bay Area, or outside California), and current employee salaries for similar roles.

Hybrid
This role requires employees to be in-office based on our hybrid workplace model, balancing purposeful in-person collaboration with flexibility. For most teams, this means coming into the office two days each week.

Physical Requirements:

Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.

Please click here for further physical requirement detail.