• Oakland, CA
    27 days ago

    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.

    Your Knowledge and Experience

    • Requires a college degree with at least a minor in mathematics, statistics, computer science or equivalent business experience

    • Requires a minimum of 3 years of professional actuarial experience

    • Requires an ASA designation or has completed the majority of the courses to complete the ASA designation

    • Requires proficiency with MS Office, including Excel, Word, PowerPoint

    • Preferred: work experience with SQL or SAS and large health care databases

    • Preferred: project management work experience

    • Preferred: work experience with provider contracting analytics

    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.

    #LI-CS1

    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

    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

    Numbers & Facts

    LocationOakland, CA
    IndustryInsurance
    Company Size2,000 to 2,499 employees
    Websitehttps://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
    • Adobe Creative Suiteunmatched
    • Analysis Skillsunmatched
    • Auditingunmatched
    • Benchmarkingunmatched
    • Cisco ASA (Adaptive Security Appliance)unmatched
    • Competitive Analysis/Strategyunmatched
    • Computer Scienceunmatched
    • Contract Analysisunmatched
    • Contract Negotiationunmatched
    • Financial Reportingunmatched
    • Financial Trend Analysisunmatched
    • Forecastingunmatched
    • Healthcareunmatched
    • Machine Learningunmatched
    • Mathematicsunmatched
    • Microsoft Excelunmatched
    • Microsoft Officeunmatched
    • Microsoft PowerPointunmatched
    • Microsoft Wordunmatched
    • Network Performance/Analysisunmatched
    • Operations Processesunmatched
    • Performance Managementunmatched
    • Predictive Modelingunmatched
    • Pricingunmatched
    • Project/Program Managementunmatched
    • Provider Contractingunmatched
    • Python Programming/Scripting Languageunmatched
    • R Programming Languageunmatched
    • Reimbursementunmatched
    • Riskunmatched
    • Risk Analysisunmatched
    • SQL (Structured Query Language)unmatched
    • Statistical Analysis System (SAS)unmatched
    • Statistical Programming Languagesunmatched
    • Statisticsunmatched
    • Team Playerunmatched
    • Trend Analysisunmatched

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