Job DescriptionYour Role The Pay for Value team supports the program design, budget setting, and operations of Blue Shield of California's value-based care (VBC) models, including Accountable Care Organization (ACO), Primary Care, Virtual Care, and other innovative programs. The Actuarial Analyst, Experienced will report to the Actuarial Director of the Pay for Value team. In this role you will support reporting and analytical work across various programs, collaborating with colleagues from diverse backgrounds and roles within the company.
ResponsibilitiesYour Work In this role, you will:
- Execute pricing, reserving, forecasting, and risk score analyses with limited supervision
- Own data pulls, quality checks, and documentation across claims, premium, membership, and risk score sources
- Maintain and enhance standard reporting to surface drivers, trends, and emerging risks
- Translate results into clear summaries for more senior actuaries and business partners
- Improve workflows and controls through template, code, and process updates
- Support VBC program reporting and analytics, including cost target setting, reconciliation, forecasting, and "what-if" modeling to inform strategy development
- Collaborate with internal teams and cross-functional partners to support VBC program development and ensure alignment with BSC healthcare affordability and quality objectives
- Perform ad-hoc actuarial analyses to support various business needs and provide actionable insights and recommendations based on these analyses
- Understand how other network initiatives and alternate payment models interplay and affect VBC programs and relationships
QualificationsYour Knowledge and Experience - Requires a bachelor's degree in mathematics, statistics, actuarial science, computer science, or a related field
- Requires 2 years of prior relevant experience building repeatable analyses and documentation using claims, premium, and membership data
- Requires demonstrated understanding of basic regulatory concepts and filing support requirements under guidance
- Requires advanced experience and skillset in Microsoft Excel and SQL
- Requires curiosity and willingness to adopt new technologies, including AI-enabled tools, to assist with analytical work, while exercising sound professional judgment
- Requires strong communication and presentation skills
- Experience with data visualization tools such as Power BI or Tableau preferred
- Prior healthcare industry experience preferred
- Completed 3 actuarial exam courses toward ASA, Fellow of the Society of Actuaries or equivalent progress preferred
HybridThis 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.
Employees living more than 50 miles from an office location will work with their manager to determine in-office time based on business need.
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.
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