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
Numbers & Facts
Location
Oakland, CA
Industry
Insurance
Company Size
2,000 to 2,499 employees
Website
https://www.bcbs.com/about-us/careers
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.
Skills
Actuarial Skillsunmatched
Analysis Skillsunmatched
Communication Skillsunmatched
Computer Scienceunmatched
Data Setsunmatched
Data Visualization Toolsunmatched
Documentationunmatched
Financial Metricsunmatched
Forecastingunmatched
Healthcareunmatched
Incentive Programsunmatched
Mathematicsunmatched
Microsoft Excelunmatched
Power BIunmatched
Presentation/Verbal Skillsunmatched
Pricingunmatched
Regulatory Submissionsunmatched
Riskunmatched
Risk Analysisunmatched
SQL (Structured Query Language)unmatched
Statisticsunmatched
Tableauunmatched
Trend Analysisunmatched
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