Experienced Actuarial Analyst – VBC Forecasting

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

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.