Senior Consulting Actuary: ACA Risk Adjustment

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

Benefits offered by this job

Medical, dental, and vision coverage

Wellness programs

Parental leave and surrogacy/adoption

Tuition reimbursement

401k match

Annual incentive bonus

Job summary

Blue Cross NC is seeking a Consulting Actuary specializing in ACA Risk Adjustment. You will lead actuarial pricing strategies, assess care management models, and design innovative insurance products. The role requires strong leadership, cross-functional collaboration, and rigorous financial stewardship.

You will engage with regulators and internal teams, ensuring compliance and advanced risk analysis while maintaining ongoing professional development in actuarial practices.

Qualifications

• Bachelor's degree or advanced degree required or preferred.
• Member of the American Academy of Actuaries.
• Fellow of the Society of Actuaries preferred; ASA considered with 9+ years of experience.

Responsibilities

• Lead pricing strategies and actuarial initiatives for business segments.
• Evaluate advanced care management models and pricing of insurance products.
• Conduct competitive benchmarking analyses and design sophisticated insurance products.
• Provide actuarial insights and recommendations; identify risks and opportunities.
• Interact with vendors, auditors, regulators, and health care providers; negotiate contracts and rates.
• Build relationships with internal partners; act as strategic advisor.
• Maintain continuing education standards for actuarial credentials.

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 or advanced degree

Member of the American Academy of Actuaries

Fellow of the Society of Actuaries

ASA with at least 9 years of actuarial experience

Job description

Blue Cross NC is seeking a Consulting Actuary specializing in ACA Risk Adjustment. You will lead actuarial pricing strategies, assess care management models, and design innovative insurance products. The role requires strong leadership, cross-functional collaboration, and rigorous financial stewardship.

You will engage with regulators and internal teams, ensuring compliance and advanced risk analysis while maintaining ongoing professional development in actuarial practices.