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Actuarial Analyst, Experienced

    Highlights

    The Value Based Care (VBC) Analytics team supports new and innovative payment models, including Accountable Care Organizations (ACO), Virtual Care, and other performance-based incentive programs. In this role you will support VBC strategies by developing, validating, and maintaining analytic datasets and reporting that inform provider performance on utilization and financial metrics.

    Numbers & Facts

    LocationOakland, CA
    IndustryInsurance
    Company Size2,000 to 2,499 employees
    Websitehttps://www.bcbs.com/about-us/careers

    Description

    Your Role

    The Value Based Care (VBC) Analytics team supports new and innovative payment models, including Accountable Care Organizations (ACO), Virtual Care, and other performance-based incentive programs. The Actuarial Analyst, Experienced, will report to the Value Based Care Analytics Senior Manager. In this role you will support VBC strategies by developing, validating, and maintaining analytic datasets and reporting that inform provider performance on utilization and financial metrics. You will collaborate with a diverse team across multiple roles and functions within the company.

    Your 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 SAS/SQL

    • 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

    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.

    Employees living more than 50 miles from an office location will work with their manager to determine in-office time based on business need.

    Your 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, provider, membership, and risk score sources
    • Draft exhibits and narratives for ACA/CMS and state filings, submissions, and internal governance reviews
    • 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

    Your 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, provider, membership, and risk score sources
    • Draft exhibits and narratives for ACA/CMS and state filings, submissions, and internal governance reviews
    • 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

    About Company

    At the Blue Cross and Blue Shield Association (BCBSA), we provide business strategy, technical support and consulting expertise to 36 Blue Cross and Blue Shield companies across the nation, employing more than 1,000 of the best strategic thinkers in the industry. We are a Brand manager that sets quality control standards for the 36 independent companies that use the Blue Cross and Blue Shield Brands, and we serve as a trade association that represents these Blue companies. It is through our involvement that the Blues companies share a united vision and strategy while also benefiting from the local strength of all member companies.

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