Lead Actuarial Analyst, Pay-for-Value Strategy

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

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.