Senior ACA Risk Adjustment Actuary - Consulting

Blue Cross and Blue Shield of North Carolina; United States; Remote; USD 144,000 - 230,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

401k with company match

Tuition reimbursement

Job summary

Blue Cross NC is seeking a Consulting Actuary to lead ACA risk adjustment initiatives, pricing strategies, and advanced care management analyses. You will benchmark competitors, forecast risk scores, and drive opportunities for profitable growth while maintaining actuarial excellence.

You’ll collaborate with internal divisions and external partners to deliver actionable insights and strategic recommendations, while upholding continuing education and professional standards.

Qualifications

• Bachelor’s degree or higher in a relevant field.
• AA actuarial credential(s) required; FSA preferred.
• 7+ years of actuarial experience in risk adjustment or healthcare.

Responsibilities

• Lead actuarial initiatives and pricing for business segments.
• Analyze ACA risk adjustment models and forecast risk scores.
• Benchmark competitive performance and optimize financial impact.
• Communicate results clearly to senior leadership and partners.
• Manage external partnerships with vendors, regulators, and providers.
• Build strong internal relationships and act as advisor.

Skills

Actuarial analysis

Leadership

Stakeholder communication

ACA risk adjustment

Education

Bachelor’s degree or advanced degree

Member of the American Academy of Actuaries

Fellow of the Society of Actuaries

7 years of actuarial experience

Job description

Blue Cross NC is seeking a Consulting Actuary to lead ACA risk adjustment initiatives, pricing strategies, and advanced care management analyses. You will benchmark competitors, forecast risk scores, and drive opportunities for profitable growth while maintaining actuarial excellence.

You’ll collaborate with internal divisions and external partners to deliver actionable insights and strategic recommendations, while upholding continuing education and professional standards.