Senior Actuarial Analyst, Pay-for-Value & VBC (Hybrid)

Blue Shield of California; California; Hybrid; USD 77,000 - 117,000; Full time

Job summary

Blue Shield of California seeks an experienced Actuarial Analyst to support reporting and analytical work across value‑based care models, including ACO, Primary Care, and Virtual Care. You will work with colleagues across diverse roles, producing pricing, forecasting, and risk score analyses while maintaining high data quality and clear communication of results.

The role emphasizes collaboration with cross‑functional teams to drive cost targets and program insights, with hybrid in-office

Qualifications

• Requires a bachelor’s degree in mathematics, statistics, actuarial science, computer science, or a related field.
• Requires 2 years of prior relevant experience building repeatable analyses and documentation using claims, premium, and membership data
• Requires demonstrated understanding of basic regulatory concepts and filing support requirements under guidance
• Requires advanced experience and skillset in Microsoft Excel and SQL
• Requires curiosity and willingness to adopt new technologies, including AI-enabled tools, to assist with analytical work, while exercising sound professional judgment
• Requires strong communication and presentation skills
• Experience with data visualization tools such as Power BI or Tableau preferred
• Prior healthcare industry experience preferred
• Completed 3 actuarial exam courses toward ASA, Fellow of the Society of Actuaries or equivalent progress preferred

Responsibilities

• Execute pricing, reserving, forecasting, and risk score analyses with limited supervision
• Own data pulls, quality checks, and documentation across claims, premium, membership, and risk score sources
• Maintain and enhance standard reporting to surface drivers, trends, and emerging risks
• Translate results into clear summaries for more senior actuaries and business partners
• Improve workflows and controls through template, code, and process updates
• Support VBC program reporting and analytics, including cost target setting, reconciliation, forecasting, and 'what-if' modeling to inform strategy development
• Collaborate with internal teams and cross-functional partners to support VBC program development and ensure alignment with BSC healthcare affordability and quality objectives
• Perform ad-hoc actuarial analyses to support various business needs and provide actionable insights and recommendations based on these analyses
• Understand how other network initiatives and alternate payment models interplay and affect VBC programs and relationships

Skills

Advanced Excel

SQL

Communication skills

Actuarial exam progress

Education

Bachelor's degree in mathematics, statistics, actuarial science, computer science, or related field

Tools

Power BI

Tableau

Job description

Blue Shield of California seeks an experienced Actuarial Analyst to support reporting and analytical work across value‑based care models, including ACO, Primary Care, and Virtual Care. You will work with colleagues across diverse roles, producing pricing, forecasting, and risk score analyses while maintaining high data quality and clear communication of results.

The role emphasizes collaboration with cross‑functional teams to drive cost targets and program insights, with hybrid in-office