Actuarial Strategy & Network Analytics Manager

Blue Cross Blue Shield of Nebraska

Omaha (NE)

On-site

USD 120,000 - 160,000

Full time

14 days+

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Job summary

Blue Cross and Blue Shield of Nebraska is seeking an experienced actuary to lead and oversee key actuarial functions that support financial performance and strategic decisions. The role focuses on pricing trends, network and area factors, provider performance, Medicare Advantage, forecasting, and related healthcare analytics, with data work in SQL, Databricks and Excel.

You will coach staff, present reports to management, and collaborate with cross-functional teams to drive solutions that

Qualifications

Bachelor's degree in actuarial science, mathematics, statistics, or related field.
Five years of experience in an actuarial role and three years in the healthcare industry.
ASA licensure/certification required or equivalent.

Responsibilities

Lead development and oversight of key actuarial functions supporting financial performance and strategic decisions.
Perform actuarial analyses related to pricing trends, network/area factors, provider performance, Medicare Advantage, and forecasting.
Manipulate and analyze data using SQL, Databricks and Excel.
Maintain and improve Pricing Trend methodology, processes, and documentation.
Oversee Medicare Advantage IBNR, quarterly & annual statements, risk adjustment analyses, and bid support.
Support the corporate reinsurance program including renewal, reporting, and reimbursement filing.
Provide VBC trend analyses and support VBC activities.
Coach and provide leadership to direct reports; present reports to management.