Senior ACA Risk Adjustment Actuary - Consulting

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

Job summary

Blue Cross and Blue Shield of North Carolina is seeking a Consulting Actuary - ACA Risk Adjustment to lead actuarial initiatives and pricing strategies across business segments. You will evaluate advanced care models, benchmark analyses, and design pricing for sophisticated insurance products while addressing risks and opportunities for profitable growth.

The role requires strong communication with leadership, collaboration with external partners, and commitment to continuing education to

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.

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

Risk Adjustment

Financial Reporting

Hiring Management

Insurance Industry

Organizational Leadership

Regulatory Compliance

Education

Bachelor's degree or advanced degree

Member of the American Academy of Actuaries

Fellow of the Society of Actuaries

7 years actuarial experience

ASA with 9 years experience (in lieu of FSA)

Job description

Blue Cross and Blue Shield of North Carolina is seeking a Consulting Actuary - ACA Risk Adjustment to lead actuarial initiatives and pricing strategies across business segments. You will evaluate advanced care models, benchmark analyses, and design pricing for sophisticated insurance products while addressing risks and opportunities for profitable growth.

The role requires strong communication with leadership, collaboration with external partners, and commitment to continuing education to