Consulting Actuary: ACA Risk Adjustment Strategy

Blue Cross and Blue Shield of North Carolina; Tennessee; On-site; USD 144,000 - 230,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Parental leave and adoption/surrogacy‑

401k match with company contribution

Tuition reimbursement

Career development programs

Work-life balance and flexibility

Job summary

Blue Cross NC is seeking a Consulting Actuary - ACA Risk Adjustment to lead pricing strategies and actuarial initiatives across business segments, evaluate advanced care management models, and design and price sophisticated insurance products. The role requires strong leadership, cross-functional communication, and the ability to oversee external vendors, regulators, and providers.

Candidates should have 7+ years of actuarial experience (ASA/FSA) and ongoing CE to maintain credentials.

Qualifications

• Bachelor’s degree or advanced degree (where required).
• Member of the American Academy of Actuaries.
• Fellow of the Society of Actuaries.
• 7 years of relevant actuarial experience, related experience may be considered.
• In lieu of an FSA, will consider candidates who are an Associate of the Society of Actuaries (ASA) and have at least 9 years of relevant actuarial experience.

Responsibilities

• Accountable for completion of complex actuarial or analytical projects, ensuring timeliness, compliance, and quality of work.
• Provide proactive and strategic thought leadership of ways to improve processes, reduce risks, and meet department and enterprise objectives to achieve profitable growth and/or improve value, quality, and access for Blue Cross NC customers.
• Achieve segment financial targets and provide concise explanations of results and variances to expectations; act as a financial steward for the company.
• Communicate effectively with all levels and divisions within the organization, including Divisional Leadership.
• Manage external partnerships with vendors, auditors, regulators, and health care providers, including effective negotiation of contracts and/or rates.
• Develop and maintain strong business relationships with internal partners through business expertise and exceptional support; act as a strategic advisor.
• Meet continuing education standards required for job function, thought leadership and maintenance of actuarial credentials

Skills

Actuarial Analysis

Actuarial Management

Actuarial Science

Actuarial Services

ACA

Complex Care Management

Financial Reporting

Hiring Management

Insurance Industry

Organizational Leadership

Regulatory Compliance

Education

Bachelor's degree

American Academy of Actuaries member

Fellow of the Society of Actuaries

Job description

Blue Cross NC is seeking a Consulting Actuary - ACA Risk Adjustment to lead pricing strategies and actuarial initiatives across business segments, evaluate advanced care management models, and design and price sophisticated insurance products. The role requires strong leadership, cross-functional communication, and the ability to oversee external vendors, regulators, and providers.

Candidates should have 7+ years of actuarial experience (ASA/FSA) and ongoing CE to maintain credentials.