Senior ACA Risk Adjustment Actuary

Blue Cross and Blue Shield of North Carolina; Cheyenne (WY); On-site; USD 144,000 - 230,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Parental leave and adoption support

Tuition reimbursement

401k match and company contribution

Work-life balance and flexibility

Job summary

Blue Cross NC is seeking a Consulting Actuary specializing in ACA Risk Adjustment to lead pricing strategies, model development, and actuarial initiatives across business segments. You will drive competitive benchmarking, analyze complex risks, and present actionable insights to senior leadership.

Ideal candidates have 7+ years in actuarial roles, AA or FSA credentials, and strong communication skills to collaborate with stakeholders and external partners in a dynamic health care environment.

Qualifications

• 7 years of relevant actuarial experience.
• Member of the American Academy of Actuaries.
• Fellow of the Society of Actuaries or ASA with >=9 years experience.
• Experience with ACA Risk Adjustment preferred.

Responsibilities

• Lead pricing strategies and actuarial initiatives for business segments.
• Evaluate advanced care management models and pricing.
• Conduct competitive benchmarking analyses and model design.
• Provide actuarial insights to support enterprise objectives.
• Identify risks and opportunities and communicate with leadership.

Skills

Actuarial Analysis

Actuarial Management

Actuarial Science

Actuarial Services

Affordable Care Act (ACA)

Complex Care Management

Financial Reporting and Analysis

Hiring Management

Insurance Industry

Organizational Leadership

Regulatory Compliance

Education

Bachelor's degree

Advanced degree

Fellow of the Society of Actuaries (FSA)

Associate of the Society of Actuaries (ASA)

Job description

Blue Cross NC is seeking a Consulting Actuary specializing in ACA Risk Adjustment to lead pricing strategies, model development, and actuarial initiatives across business segments. You will drive competitive benchmarking, analyze complex risks, and present actionable insights to senior leadership.

Ideal candidates have 7+ years in actuarial roles, AA or FSA credentials, and strong communication skills to collaborate with stakeholders and external partners in a dynamic health care environment.