Actuarial Analyst, Experienced

Blue Shield Of California; Long Beach (CA); Hybrid; USD 90,000 - 120,000; Full time

Job summary

Blue Shield of California's Pay for Value team seeks an experienced Actuarial Analyst to support reporting, pricing, forecasting, and risk-score analyses across value-based care programs. You will own data pulls, ensure data quality, and translate results for senior actuaries and business partners.

The role emphasizes collaboration with cross-functional teams, standard reporting development, and exploring AI-enabled tools to enhance analytics while upholding regulatory and affordability goals.

Qualifications

• Requires a bachelor’s degree in mathematics, statistics, actuarial science, computer science, or related field.
• Requires 2 years of prior relevant experience building repeatable analyses and documentation using claims, premium, and membership data.
• Requires understanding of basic regulatory concepts and filing support requirements under guidance.
• Requires advanced experience and skillset in Microsoft Excel and SQL.
• Open to adopting AI-enabled tools to assist analytics with sound judgment.

Responsibilities

• Execute pricing, reserving, forecasting, and risk score analyses with limited supervision
• Own data pulls, quality checks, and documentation across claims, premium, membership, and risk score sources
• Maintain and enhance standard reporting to surface drivers, trends, and emerging risks
• Translate results into clear summaries for senior actuaries and business partners
• Improve workflows and controls through template, code, and process updates
• Support VBC program reporting and analytics, including cost target setting, reconciliation, forecasting, and what-if modeling
• Collaborate with internal teams and cross-functional partners to support VBC program development and align with affordability and quality goals
• Perform ad-hoc actuarial analyses to provide actionable insights
• Understand how other network initiatives and alternate payment models interplay with VBC programs

Skills

Excel

SQL

Data analysis

Communication

AI tools

Power BI

Tableau

Healthcare exp

Education

Bachelor's degree

Tools

Power BI

Tableau

Job description

Your Role

The Pay for Value team supports the program design, budget setting, and operations of Blue Shield of California’s value-based care (VBC) models, including Accountable Care Organization (ACO), Primary Care, Virtual Care, and other innovative programs. The Actuarial Analyst, Experienced will report to the Actuarial Director of the Pay for Value team. In this role you will support reporting and analytical work across various programs, collaborating with colleagues from diverse backgrounds and roles within the company.

Responsibilities

Your Work

In this role, you will:

• Execute pricing, reserving, forecasting, and risk score analyses with limited supervision
• Own data pulls, quality checks, and documentation across claims, premium, membership, and risk score sources
• Maintain and enhance standard reporting to surface drivers, trends, and emerging risks
• Translate results into clear summaries for more senior actuaries and business partners
• Improve workflows and controls through template, code, and process updates
• Support VBC program reporting and analytics, including cost target setting, reconciliation, forecasting, and "what-if" modeling to inform strategy development
• Collaborate with internal teams and cross-functional partners to support VBC program development and ensure alignment with BSC healthcare affordability and quality objectives
• Perform ad-hoc actuarial analyses to support various business needs and provide actionable insights and recommendations based on these analyses
• Understand how other network initiatives and alternate payment models interplay and affect VBC programs and relationships

Qualifications

Your Knowledge and Experience

• Requires a bachelor’s degree in mathematics, statistics, actuarial science, computer science, or a related field

• Requires 2 years of prior relevant experience building repeatable analyses and documentation using claims, premium, and membership data
• Requires demonstrated understanding of basic regulatory concepts and filing support requirements under guidance
• Requires advanced experience and skillset in Microsoft Excel and SQL
• Requires curiosity and willingness to adopt new technologies, including AI-enabled tools, to assist with analytical work, while exercising sound professional judgment
• Requires strong communication and presentation skills
• Experience with data visualization tools such as Power BI or Tableau preferred
• Prior healthcare industry experience preferred
• Completed 3 actuarial exam courses toward ASA, Fellow of the Society of Actuaries or equivalent progresspreferred

Hybrid

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 isa 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 Fair360 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!

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 listen and communicate effectively, showing empathy by understanding others' perspectives.
• Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.

OurWorkplace Model

We believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility - providing clear expectations while respecting the diverse needs of our workforce. Ourworkplace modelis designed around intentional in-person interaction, collaboration, connection,creativityand flexibility:

• For most teams, this means coming into the office two days per week.

• Employees living more than 50 miles from an office location, out of state employees, and employees in certain member-facing roles should work with their manager to determine in-office time based on business need.

• For employees with medical conditions that may impact their ability to work in-office, we are committed to engaging in an interactive process and providing reasonable accommodations to ensure their work environment is conducive to their success and well-being.

The Company reserves the right torequiremore presence in the office based on business needs, and requirements are subject to change with periodic reviews.

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.

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.