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Blue Cross & Blue Shield of Rhode Island is seeking an experienced Actuary to support actuarial and financial functions related to pharmacy benefit programs. You will analyze claims experience, drug utilization, cost trends, and financial performance to aid pricing, forecasting, and strategy.
The role requires a Mathematics/Economics degree and ASA designation, with 3–5 years of actuarial experience. Flexible schedules include in-office, hybrid, and remote options to fit work-life balance.
$116,900.00 - $187,100.00
Please email HR_Talent_AcquisitionTeam@bcbsri.org if you are a candidate seeking a reasonable accommodation for the application and/or interview process.
At BCBSRI, our greatest resource is our people.
We come from varying backgrounds, different cultures, and unique experiences. We are hard-working, caring, and creative individuals who collaborate, support one another, and grow together. Passion, empathy, and understanding are at the forefront of everything we do—not just for our members, but for our employees as well.
It’s why we offer flexible work arrangements that include remote and hybrid opportunities and paid time off. We provide tuition reimbursement and assist with student-loan repayment. We offer health, dental, and vision insurance as well as programs that support your mental health and well-being. We pay competitively, offer bonuses and investment plans, and are committed to growing and developing our employees.
We strive to be transparent and accountable. We believe in equipping our associates with the knowledge and resources they need to be successful. No matter where you’re at in the organization, you’re an integral part of our team and your input, thoughts, and ideas are valued.
We appreciate and celebrate everything that makes us unique, from personal characteristics to past experiences. Our different perspectives strengthen us as an organization and help us better serve all Rhode Islanders.
Our focus extends beyond providing access to high-quality, affordable, and equitable care. To further improve the health and well-being of our fellow Rhode Islanders, we regularly roll up our sleeves and get to work (literally) in communities all across the state—building homes, working in food pantries, revitalizing community centers, and transforming outdoor spaces for children and adults. Because we believe it is our collective responsibility to uplift our fellow Rhode Islanders when and where we can, our associates receive additional paid time to volunteer.
The Actuary will support a broad range of actuarial and financial functions related to BCBSRI’s pharmacy benefit programs. This highly visible role requires extensive analysis of pharmacy claims experience, drug utilization, cost trends, and financial performance to support pricing, forecasting, product strategy, and pharmacy benefit management initiatives.
Monitor, analyze, and report on the effectiveness of the existing rating formula. Perform financial forecasting and trend analysis.
Develop statistical and actuarial models to assist in the analysis of rate and reserve adequacy. Evaluate corporate loss reserves.
Design and write computer programs to extract data from various databases. Extract and analyze claims, enrollment, and general health insurance data.
Prepare regulatory reporting requirements.
Participate in department initiatives and projects.
Perform other duties as assigned.
Bachelor’s degree in Mathematics, Economics, or related field, or an equivalent combination of education and experience
Three to five years actuarial experience
ASA Society of Actuaries designation
Ability to interpret and perform financial forecasting, statistical modeling, and trend analysis
Advanced analytical skills, with the ability to interpret and synthesize complex data sets
Good business acumen and political savvy
Knowledge of business process improvement techniques and strategies
Excellent verbal and written communications skills
Negotiation skills
Presentation skills
Decision-making skills
Good problem solving skills
Ability to interface with employees at all levels
Ability to effectively navigate ambiguous situations with limited direction
Excellent organizational skills and ability to successfully prioritize multiple tasks
Ability to handle multiple priorities/projects
BCBSRI is headquartered in downtown Providence, conveniently located near the train station and bus terminal. We actively support associate well-being and work/life balance and offer the following schedules, based on role:
Our culture of belonging at Blue Cross & Blue Shield of Rhode Island (BCBSRI) is at the core of all we do, and it strengthens our ability to meet the challenges of today’s healthcare industry. BCBSRI is an equal opportunity employer.
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