Blue Shield of California's mission is to ensure all Californians have access to high-quality health care at a sustainably affordable price. We are transforming health care in a way that truly serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.
To fulfill our mission, we must ensure a diverse, equitable, and inclusive environment where all employees can be their authentic selves and fully contribute to meet the needs of the multifaceted communities we serve. Our comprehensive approach to diversity, equity, and inclusion combines a focus on our people, processes, and systems with a deep commitment to promoting social justice and health equity through our products, business practices, and presence as a corporate citizen.
Blue Shield has received awards and recognition for being a certified Great Place to Work, best place to work for LGBTQ equality, leading disability employer, one of the best companies for women to advance, Bay Area's top companies in volunteering & giving, and one of the world's most ethical companies. Here at Blue Shield of California, we are striving to make a positive change across our industry and the communities we live in - join us!
Your Role
Reporting to the Director of Large Group Pricing, the role of Senior Actuarial Analyst will be primarily responsible for pricing factor development and rating model oversight. This role will be heavily involved in automating factor updates and improving the accuracy of our pricing model to help us stay ahead of our competition, while attaining critical leadership signoffs in a timely manner. They will also be active in our pricing cycles, ensure consistency in our financial projections, and be a significant contributor to analytics related to optimizing our profitability.
The Large Group Pricing team is very collaborative, giving this position well-rounded exposure to all actuarial functions supporting our Core, Premier, GMAPD, and ASO lines of business. The Senior Actuarial Analyst will have the opportunity to mentor other analysts and manage workflows, and will build valuable relationships with our Corporate Actuarial Rating Model team, Underwriting, and Product.
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
Can train lower level analysts on how to update and apply these advanced analytic techniques. Can explain purpose and basic functionality of these advanced analytic techniques to audiences outside of their job function
Acts as the subject matter expert in the data areas of claim, premium, membership, and/or risk score assignment
Maintains documentation or actuarial analysis and models as well as provides consultation and clarification on actuarial models and other Actuarial work products Develops evaluation and financial reporting standards for internal and external reports
Your Knowledge and Experience
Requires a bachelor's degree with at least a minor in mathematics, statistics, computer science or equivalent business experience
At least 3 years of professional actuarial experience
Requires advance knowledge of job area obtained through professional experience and advanced education.
Typically requires a minimum of 3 to 5 years of professional actuarial experience.
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 be our authentic selves, listening and communicating effectively, and showing empathy towards others by walking in their shoes
Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals
Additional Information
About Company: o About Blue Shield of California: For more than 80 years, Blue Shield 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 7,500 employees, more than $21 billion in annual revenue and 4.5 million members. The company has contributed more than $500 million to the Blue Shield of California Foundation since 2002 to have a positive impact on California communities. Blue Shield is headquartered in Oakland, California with 21 additional locations including Sacramento, Los Angeles, and San Diego. o Our Benefits: At Blue Shield you can expect a comprehensive benefits program that offers choice and flexibility for our diverse workforce. These programs and resources include: Medical, Dental, and Vision plan benefits, 401(k) with employer match, paid time off (PTO), earned sabbatical time, paid nonprofit volunteer time, flexible work program, free online education, tuition reimbursement, a wellness reimbursement program, 12 weeks paid parental leave, and more.
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. Please click here for further physical requirement detail.
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. COVID-19 update: From the earliest days of the pandemic, Blue Shield of California has been unyielding in our commitment to putting the health and safety of our people, our members and our communities first. As a federal contractor and a health care company, Blue Shield requires all employees to be fully vaccinated prior to start date as a condition of employment and provide proof of vaccination status. Blue Shield will consider requests for medical or religious accommodation to this vaccination requirement prior to your start date
