Job Description
Job Description Your Role The Network & Trend Analytics (NTA) team provides analytical and strategic support for BSC provider contract negotiations and performance management in collaboration with other departments. Our work is essential for us to fulfill our mission. The Actuarial Analyst, Senior will report to the Actuarial Analyst, Principal. In this role you will develop actuarial models to support contract negotiations, perform benchmarking studies, work on presentations for strategic meetings for senior executives as well as meet other business needs. Responsibilities Your Work In this role, you will: Understand the core principles and functionality of decision, descriptive and predictive 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 evaluates 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 a combination of statistical programming languages (including, but not limited R, Python, SQL, SAS) and deploys predictive analytics and machine learning techniques to improve risk prediction, improve reserve, trend and financial forecasting in a manner that is actuarially sound, and enable real-time results and operational efficiencies Develop evaluation and financial reporting standards for internal and external reports Develop presentations for senior-executive strategic meetings by working with different teams, including performing various actuarial studies using different tools (Excel, SAS, SQL, etc.) Conduct benchmarking, BSC health care spend, price transparency and competitive studies leveraging internal and external data sources Be able to work under a fast-paced organization Qualifications Your Knowledge and Experience Requires a college degree with at least a minor in mathematics, statistics, computer science or equivalent business experience May have an ASA designation or has completed the majority of the courses to complete the ASA designation Requires at least 3 years of professional actuarial experience Requires proficiency with MS Office, including Excel, Word, PowerPoint Preferred: work experience with SQL or SAS Preferred: project management work experience Preferred: work experience with provider contracting analytics About Us About Blue Shield of California As of January 2025, Blue Shield of California became a subsidiary of Ascendiun. Ascendiun is a nonprofit corporate entity that is the parent to a family of organizations including Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan; Altais, a clinical services company; and Stellarus, a company designed to scale healthcare solutions. Together, these organizations are referred to as the Ascendiun Family of Companies. At Blue Shield of California, our mission is to create a healthcare system worthy of our family and friends and sustainably affordable. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience. To achieve our mission, we foster an environment where all employees can thrive and contribute fully to address the needs of the various communities we serve. We are committed to creating and maintaining a supportive workplace that upholds our values and advances our goals. Blue Shield is a U.S. News Best Company to work for, a Deloitte U.S. Best Managed Company and a Top 100 Inspiring Workplace. We were recognized by Fair360 as a Top Regional Company, and one of the 50 most community-minded companies in the United States by Points of Light. Here at Blue Shield, we strive to make a positive change across our industry and communities – join us! Our Values: Honest. We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short. Human. We strive to listen and communicate effectively, showing empathy by understanding others' perspectives. Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals. Our Workplace Model