Principal Actuary, Cost of Care

Blue Cross and Blue Shield of North Carolina; North Carolina; Hybrid; USD 119.000 - 190.000; Vollzeit

Benefits dieser Stelle

Medical benefits

Dental benefits

Vision benefits

401k match

Parental leave

Tuition reimbursement

Zusammenfassung

Blue Cross NC is seeking a Principal Actuary to deliver actuarial and analytical work across pricing, strategy, and cost containment initiatives. The role focuses on performance evaluations of existing and proposed initiatives in clinical, pharmacy, network, payment integrity, and value-based care areas.

You will lead complex projects, communicate across leadership levels, and manage external partnerships while maintaining actuarial credentials.

Qualifikationen

• Bachelor's degree or advanced degree ASA designation (FSA preferred); exam takers may be considered based on other experience
• 5+ years of relevant actuarial experience
• Bonus Points SQL-based data queries and data management
• Experience with data visualization applications such as Power BI and Tableau
• Experience creating and presenting external, client-facing materials and reports

Aufgaben

• 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
• Develop measurement models for various cost savings initiatives across the company’s many strategic areas including, but not limited to clinical care management, alternative payment arrangements with providers, medical coding and policy adherence practices, and other emerging drivers of trend

Kenntnisse

Strategic thinking

Communication skills

Leadership

Ausbildung

Bachelor's or advanced degree; ASA designation (FSA preferred)

Tools

SQL

Power BI

Tableau

Jobbeschreibung

Job Description

The Principal Actuary delivers a broad range of actuarial or analytical work for the company, such as conducting pricing and actuarial strategy for a business segment, evaluating advanced care management models, performing competitive benchmarking analysis, and conducting economic value evaluation of cost containment initiatives. They support the company strategy by providing sound, consistent, and actionable actuarial analysis and recommendations, and can identify and react to nuanced risks and opportunities. This particular role will focus on performance evaluations for both existing initiatives within the Cost of Care portfolio and newly proposed initiatives across several different subject areas including clinical, pharmacy, network, payment integrity, value-based care, and more.

What You’ll Do

• 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
• Develop measurement models for various cost savings initiatives across the company’s many strategic areas including, but not limited to clinical care management, alternative payment arrangements with providers, medical coding and policy adherence practices, and other emerging drivers of trend

What You Bring

• Bachelor's degree or advanced degree in related field ASA designation (FSA preferred); exam takers may be considered based on other experience
• 5+ years of relevant actuarial experience, related experience may be considered
• Bonus Points SQL-based data queries and data management
• Experience with data visualization applications such as Power-BI and Tableau
• Experience creating and presenting external, client-facing materials and reports

What You’ll Get

The opportunity to work at the cutting edge of health care delivery with a team that’s deeply invested in the community. Work-life balance, flexibility, and the autonomy to do great work. Medical, dental, and vision coverage along with numerous health and wellness programs. Parental leave and support plus adoption and surrogacy assistance. Career development programs and tuition reimbursement for continued education. 401k match including an annual company contribution.

Salary Range

At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs. Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs. *Based on annual corporate goal achievement and individual performance.

$118,691.00 - $189,906.00

About Us

It’s an exciting time to work at Blue Cross and Blue Shield of North Carolina (Blue Cross NC). Health care is changing, and we’re leading the way. We offer more than health insurance our customers can count on. We’re committed to better health and better health care − in our communities and beyond. Our employees bring energy and creativity to the workplace, and it shows in our innovative approach to improving the health and well‑being of North Carolinians. Blue Cross NC is a fully taxed, not‑for‑profit company headquartered in Durham, North Carolina. We serve more than 4.3 million members, and we employ more than 5,000 people across the country who are passionate about making health care better for all. Help us lead the charge for better health care by joining our award‑winning team. Discover tremendous opportunities with us to do challenging and rewarding work. Opportunities that can lead you to a fulfilling career, work that can help others lead healthier, happier lives.

Authorization to Work in the United States

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Request Accommodations

Blue Cross NC provides reasonable accommodations to applicants with disabilities. If you need a reasonable accommodation for any part of the application or hiring process, please notify HR at [e-mail].

Hybrid Flex Company

Blue Cross NC is a Hybrid Flex company. Whether the role is Hybrid Flex or Remote Flex depends on the nature of the work and distance from our Durham headquarters. We welcome candidates from outside the local area and in any of our approved states: Alabama, Arizona, Arkansas, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin, and Wyoming.