Senior ACA Risk Adjustment Actuary | Strategic Leader

Blue Cross and Blue Shield of North Carolina; Philadelphia (Philadelphia County); 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 pricing strategies and actuarial initiatives across business segments. The role focuses on evaluating care management models, benchmarking, and pricing sophisticated insurance products, delivering reliable actuarial insights.

The candidate will address complex risks, communicate with leadership, and manage external partnerships while maintaining professional credentials and up-to-date

Qualifications

• Bachelor's degree or advanced degree as required.
• Member of the American Academy of Actuaries.
• Fellow of the Society of Actuaries or ASA with substantial experience.

Responsibilities

• Lead pricing strategies and actuarial initiatives for business segments.
• Evaluate advanced care management models and pricing sophisticated products.
• Conduct benchmarking analyses and provide actionable actuarial insights.
• Identify risks and opportunities and communicate with leadership.
• Manage vendor, regulator, and provider partnerships and negotiations.
• Build strong internal partnerships and act as strategic advisor.
• Meet continuing education standards for actuarial credentials.

Skills

Actuarial Analysis

Actuarial Management

Actuarial Science

Actuarial Services

ACA Expertise

Complex Care Management

Financial Reporting

Hiring Management

Insurance Industry

Organizational Leadership

Regulatory Compliance

Education

Bachelor's degree

Member of the American Academy of Actuaries (MAAA)

Fellow of the Society of Actuaries (FSA)

Associate of the Society of Actuaries (ASA) with 9+ years experience

Job description

Blue Cross and Blue Shield of North Carolina is seeking a Consulting Actuary - ACA Risk Adjustment to lead pricing strategies and actuarial initiatives across business segments. The role focuses on evaluating care management models, benchmarking, and pricing sophisticated insurance products, delivering reliable actuarial insights.

The candidate will address complex risks, communicate with leadership, and manage external partnerships while maintaining professional credentials and up-to-date