Actuarial Analyst, Principal

Blue Shield of California; California (MO); Hybrid; USD 149,000 - 223,000; Full time

Job summary

Blue Shield of California seeks an Actuarial Pay for Value Analyst, Principal, to partner with executive leaders in advancing value-based care models and affordability initiatives. This highly visible role oversees a two-person team and shapes strategy across enterprise pay-for-value programs.

You will develop advanced analytics, pricing, forecasting, and vendor evaluations while driving cross-functional execution from concept to implementation in a hybrid environment.

Qualifications

• Requires a college degree in mathematics, statistics, actuarial science, economics, computer science or equivalent business experience.
• Requires an ASA and must be working towards FSA if not complete
• Requires at least 8 years of professional actuarial experience
• Experience leading complex actuarial and strategic initiatives with significant organizational impact
• Expert-level proficiency in Excel and analytical programming languages such as SQL, Python, and SAS with financial modeling and forecasting experience
• Experience mentoring actuarial analysts and quantitative professionals
• Ability to communicate complex actuarial findings to technical and non-technical audiences
• Desired experience with Tableau, Power BI, dashboards and executive reporting tools

Responsibilities

• Understand core principles and functionality of decision, descriptive, predictive, and prescriptive analytic methods
• Conduct and develop analysis, assess risk and population risk scores and assignment, develop pricing and trends, reserve development and forecasting
• Coordinate, prepare, perform, and audit actuarial analyses for pricing, trending, reserving and risk assessment strategies
• Perform data exploration using Python, SQL, SAS and deploy predictive analytics to improve forecasting and efficiencies
• Lead strategic, market and competitive analyses
• Lead innovative payment and value-based care strategies addressing healthcare challenges
• Develop and evaluate complex financial models, ROI analyses, savings assessments and vendor evaluations
• Lead cross-functional collaboration across business, clinical, operational, technology, finance and provider stakeholders
• Develop visually compelling analytical tools, dashboards and executive reporting packages
• Manage and mentor a team of two actuarial professionals

Skills

Excel

SQL

Python

SAS

Leadership

Communication

Tableau

Power BI

Tools

Tableau

Power BI

Job description

Your Role

The Actuarial Pay for Value team serves as a strategic partner to Blue Shield leadership in developing innovative payment models, value-based care strategies, and provider incentives that advance affordability, quality, provider performance, and member outcomes across the enterprise. The Actuarial Analyst, Principal will report to the Senior Manager, Actuarial Pay for Value and directly manage a team of two actuarial professionals. In this highly visible leadership role, you will work directly with senior and executive leaders across Blue Shield to shape and execute key enterprise strategies, design creative solutions to complex healthcare challenges, evaluate emerging market opportunities, and drive transformational initiatives from concept through implementation.

Combining actuarial expertise, strategic thinking, innovation, and people leadership, you will help define the future direction of Blue Shield's Pay for Value programs and provider partnerships while delivering measurable impact on the organization's long-term affordability, quality, and value-based care objectives. This role will have significant visibility with senior leadership and influence some of Blue Shield's most critical affordability, provider transformation, and value-based care initiatives.

Responsibilities

In this role, you will:

• Understand the core principles and functionality underlying decision, descriptive, predictive, and prescriptive advanced analytic methods
• 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 evaluate 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 analytical programming languages including Python, SQL, and SAS, and deploy predictive analytics and machine learning techniques to improve forecasting, financial modeling, risk prediction, and operational efficiencies
• Lead, coordinate and/or develop strategic, market and competitive analysis
• Lead innovative payment and value-based care strategies that address complex healthcare challenges and drive affordability, quality, provider performance, and member outcomes
• Lead development and evaluation of complex financial models, forecasting methodologies, ROI analyses, savings assessments, accrual methodologies, and vendor evaluations to support strategic business decisions
• Lead cross-functional collaboration across business, clinical, operational, technology, finance, and provider stakeholders to drive organizational change, translate strategic concepts into actionable plans, build alignment, navigate ambiguity, resolve complex issues, and implement initiatives from ideation through execution
• Develop innovative, visually compelling, and professionally designed analytical tools, dashboards, forecasting models, and executive reporting packages that transform complex data into actionable insights and support strategic decision-making
• Manage, mentor, and guide a team of two actuarial professionals by providing coaching, technical leadership, and career development support while helping team members navigate ambiguity, evolving priorities, and complex business challenges

Qualifications

Your Knowledge and Experience

• Requires a college degree in mathematics, statistics, actuarial science, economics, computer science or equivalent business experience
• Requires an ASA and must be working towards FSA if not complete
• Requires at least 8 years of professional actuarial experience
• Required experience leading complex actuarial and strategic initiatives with significant organizational impact, influencing decisions without direct authority, driving alignment across cross-functional stakeholders, and managing multiple priorities in a dynamic environment
• Required expert-level proficiency in Excel and analytical programming languages such as SQL, Python, and SAS, with demonstrated experience developing sophisticated financial models, forecasting methodologies, pricing and savings analyses, analytical frameworks, automation solutions, and scalable decision-support tools
• Required experience managing, mentoring, and developing actuarial analysts or other quantitative professionals, including performance management, coaching, technical development, and career growth
• Required ability to communicate complex actuarial findings and strategic recommendations to technical and non-technical audiences, including senior and executive leadership
• Desired experience with Tableau, Power BI, data visualization technologies, dashboard development, reporting automation, executive reporting solutions, and visually compelling decision-support tools

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 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 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.

Our Workplace 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. Our workplace model is designed around intentional in-person interaction, collaboration, connection, creativity and 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 to require more 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.

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

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.

JOB INFO

• Job Identification : 20261471
• Job Category : Actuarial Services
• Posting Date : 2026-08-05T18:24:03+00:00
• Job Schedule : Full time
• Locations :
• Oakland, CA, United States
• CA, United States
• Pay Range for California : $148940.00 to $223300.00
• Pay Range for Bay Area : $167896.00 to $251720.00
• Note : Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate experience, location (California, Bay Area, or outside California), and current employee salaries for similar roles.
• Role can be filled by a candidate requiring sponsorship : No