Actuarial Analyst, Consultant

Overview

Your Role The Risk Adjustment Analytics and Reporting team is looking for a Consultant Actuarial Analyst. The Consultant Actuarial Analyst will report to the Senior Manager of Risk Adjustment Analytics and Reporting. In this role you will help provide analytical support for various prospective programs across multiple lines of business. This involves working closely with risk adjustment models, member targeting and tracking, financial forecasting, and various other analytical requests.

Job Description The Risk Adjustment Analytics and Reporting team is looking for a Consultant Actuarial Analyst. The Consultant Actuarial Analyst will report to the Senior Manager of Risk Adjustment Analytics and Reporting. In this role you will help provide analytical support for various prospective programs across multiple lines of business. This involves working closely with risk adjustment models, member targeting and tracking, financial forecasting, and various other analytical requests.

Your Work In this role, you will:

• Understand the core principles and functionality of decision, descriptive, predictive, and prescriptive 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 deploy 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
• Direct, coordinate, and/or develop evaluation and financial reporting standards for internal and external reports
• Perform vendor return on investment analyses to determine ongoing benefit and decision support
• Lead initiatives to improve processes and propose creative ideas that enhance experience of stakeholders and team. Guide and review work of Junior Analysts.
• Perform other responsibilities as assigned

Your Knowledge and Experience

• Requires a college degree with at least a minor in mathematics, statistics, computer science or equivalent business experience
• Requires at least 6 years of professional actuarial experience
• Requires one to be an independent, proactive problem solver with patience for working on large scale problems
• Requires strong technical skills
• Requires programming knowledge (SQL, SAS and/or VBA preferred), including sample code (in any language)
• Requires proficiency with Microsoft Excel
• Typically has obtained their ASA designation and has completed 1 to 2 courses toward their FSA designation

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.

About Blue Shield of California As of January 2025, Blue Shield of California became a subsidiary of Ascendiun. Ascendiun is a nonprofit corporate entity that is the parent to a family of organizations including Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan;
Altais, a clinical services company; and Stellarus, a company designed to scale healthcare solutions. Together, these organizations are referred to as the Ascendiun Family of Companies. At Blue Shield of California, our mission is to create a healthcare system worthy of our family and friends and sustainably affordable. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.

To achieve our mission, we foster an environment where all employees can thrive and contribute fully to address the needs of the various communities we serve. We are committed to creating and maintaining a supportive workplace that upholds our values and advances our goals. Blue Shield is a U.S. News Best Company to work for, a Deloitte U.S. Best Managed Company and a Top 100 Inspiring Workplace.

We were recognized by Fair
360 as a Top Regional Company, and one of the 50 most community-minded companies in the United States by Points of Light. Here at Blue Shield, we strive to make a positive change across our industry and communities – join us!

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