Actuarial Services Trend & Network Lead

Blue Cross and Blue Shield of Nebraska; Omaha (NE); On-site; USD 120,000 - 180,000; Full time

Job summary

Blue Cross and Blue Shield of Nebraska is seeking an experienced actuary to lead the development and oversight of key actuarial functions that support financial performance and strategic decision-making.

You will analyze pricing trends, network and area factors, provider performance, Medicare Advantage and risk adjustment, while guiding forecasting and related healthcare analytics; collaboration with cross-functional teams is essential.

Qualifications

• Bachelor's degree in actuarial science, mathematics, statistics, or related field.
• Five years of experience in an actuarial role and three years of experience in the health care industry.
• ASA Licensure/Certification.

Responsibilities

• Lead the development and oversight of key actuarial functions to support financial performance and strategic decision-making.
• Guide actuarial analyses related to pricing trends, network and area factors, and provider performance; support Medicare Advantage and risk adjustment initiatives.
• Oversee the monthly Medicare Advantage IBNR, Quarterly & Annual Statement, and related projects; support the bid process.

Skills

SQL

Databricks

Excel

Education

Bachelor's degree in actuarial science, Mathematics, Statistics, or related field

ASA Licensure/Certification

Job description

Blue Cross and Blue Shield of Nebraska is seeking an experienced actuary to lead the development and oversight of key actuarial functions that support financial performance and strategic decision-making.

You will analyze pricing trends, network and area factors, provider performance, Medicare Advantage and risk adjustment, while guiding forecasting and related healthcare analytics; collaboration with cross-functional teams is essential.