Job Description:

Actuarial Operations: Responsible for pricing, risk management, reserving, forecasting, trend setting and actuarial administration including conducting analysis, monitoring, evaluating, and reporting of the effectiveness of rating formula and participating in the development of new products. Actuarial

Analyst - Reporting to the Senior Director, Corporate Actuarial, the role of Principal, Altais Actuarial Support is critical to the shared success of Altais and Blue Shield of California. This role will provide dedicated, independent actuarial and financial support to Altais related to value based care models and provider practice support.

Job Details:

* Value Based Care Support

* Provides actuarial support and modeling for value-based care models Altais markets directly to providers and/or health plans

* May rely on existing value-based care models developed by Blue Shield staff as starting point

* Making modifications as needed to BSC value-based care models based on Altais direction and Altais client specifications

* Supporting Altais as needed in the development of value propositions for these models (e.g. support engagement of the Altais clients, typically providers) external support

* Responsible for monitoring performance of Altais value-based care models

* Propose pricing and metrics levers for value-based contracts

* Negotiation support for value-based payment structures with providers

* Provider Performance Monitoring and Incentives:

- Creation of incentive plans for doctors in Altais provider practices

- Monitoring and reporting on performance of doctors in Altais provider practices

- Analysis, monitoring, and reporting must be across all the providers and members (not just Blue Shield)

Qualifications and Competencies

* Minimum of 10 years of actuarial experience with at least 2 in management

* Bachelor's degree required

* FSA/MAAA certification preferred, but not required

* Experience with both traditional and innovative provider payment models

* Experience with creating/designing Models that support the Altais in a transparent manner

* Experience with general financial analysis, ROI development, etc.

* In depth understanding of provider payment models with knowledge on emerging new value based care payment models

* Strong big picture knowledge of health plan and provider group interdependencies

* Ability to work independently, confidentially, but appropriately leverage support and expertise from Blue Shield staff

* Ability to work collaboratively with others, but also possess strong influencing skills to ensure Altais' on-going set up for success

* Strong communication skills, must explain complex actuarial work simply and connect it to business results

Additional Information

- Our Company: At Blue Shield of California we are parents, leader, students, visionaries, heroes, and providers. Everyday we come together striving to fulfill our mission, to ensure all Californians have access to high-quality health care at a sustainably affordable price. For more than 80 years, Blue Shield of California has been dedicated to transforming health care by making it more accessible, cost-effective, and customer-centric. We are a not-for-profit, independent member of the Blue Cross Blue Shield Association with 6,800 employees, more than $20 billion in annual revenue and 4.3 million members. The company has contributed more than $500 million to Blue Shield of California Foundation since 2002 to have a positive impact on California communities. Blue Shield of California is headquartered in Oakland, California with 18 additional locations including Sacramento, Los Angeles, and San Diego. We're excited to share Blue Shield of California has received awards and recognition for - LGBT diversity, quality improvement, most influential women in corporate America, Bay Area's top companies in volunteering & giving, and one of the world's most ethical companies. Here at Blue Shield of California, we're striving to make a positive change across our industry and the communities we live in - Join us!

- 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.

- Equal Employment Opportunity: External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.

- Requisition ID: 200026B

- Posting Date: Nov 11, 2020

- Schedule: Full-time

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