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, provides Actuarial department with pricing support, calculating reserves, risk assessment/analysis, data reporting, financial forecasting/projections, creating filings and/or performing financial and risk analysis in changes to provider contracts to help meet company goals of providing low-cost healthcare and meeting earnings objectives.
This position is for the Medicare Pricing team which includes Medicare Advantage, Part D and Medicare Supplemental plans. Responsibilities include data reconciliation, bid support, pricing and ad hoc analysis and presentation of findings to drive business strategy and performance.
May perform a combination of the following depending on discipline/dept.
Understands the core principles and functionality of decision and descriptive analytics including analyzing historical data, past performance and trends.
Has knowledge of the requisite analytic tools and techniques and can apply them to new situations under direction of supervisor.
Begins to become a subject matter expert in the data areas of claim, premium, membership, and/or risk score assignment.
Conduct 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.
Usually assigned to a line of bus or unit for analyzing loss and expense reserves, developing rate indicators, evaluating pricing levels, analyzing profitability and communicating results to more senior actuaries.
Assists in preparing the actuarial portions of the financial statements and the federal income tax returns.
Maintains, produces and/or reviews timely production of various standard analytic reports for internal and/or external use.
Other duties as assigned.
Requires college degree with at least a minor in mathematics, statistics, computer science or equivalent business experience.
Typically, has completed 3 courses towards the eventual attainment of the Associate, Society of Actuaries (ASA) designation.
Requires practical knowledge of job area obtained through professional experience and advanced education.
Typically requires a minimum of 2 to 3 years of professional actuarial experience.
Expertise working with MS office suite with advanced skills in MS Excel, SAS (Statistical Analysis System) and/or VBA (Visual Basic for Applications).
About 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!
EEO Footer: 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.