Actuarial Analyst, Senior

Your Role   The Actuarial Provider Strategies team supports the budget setting, program design, and operations of Blue Shield of California's value based care (VBC) payment models, which includes Accountable Care Organization (ACO) and other innovative, alternative payment models. The Actuarial Analyst - Senior will report to the Principal of Actuarial Provider Strategies. In this role you will have responsibility evaluating the performance of Blue Shield of California's value-based care models, including cost, utilization and quality assessment.     Your Work   In this role, you will: Understand the core principles and functionality of decision, descriptive, predictive and prescriptive analytic methods including forecasting, statistical and machine learning techniques  Support the evaluation studies, from planning, alignment with stakeholders, data gathering, analysis, review, communication, to write-up. Perform data exploration using a combination of statistical programming languages (including, but not limited R, Python, SQL, SAS) and deploy actuarial and statistical techniques to evaluate the value-based care models with clear outcome and deliverable  Direct, coordinate, and/or develop evaluation and financial reporting standards for internal and external reports Support production of the final evaluation deliverables encompassing cost, utilization and quality assessment and synthesize the results for general audience's understanding for all of Blue Shield of California's value-based care models.  This can be done via presentations, memos, external publications, or all of the above. Research clinical and financial outcome from other like value-based care programs in the industry Work with other colleagues from different areas to solution for the business problems; this may involve presenting either verbally or in written format to key stakeholders or leadership  Your Knowledge and Experience   Requires a bachelor's degree with at least a minor in mathematics, statistics, computer science or equivalent business experience Requires at least 3 years of professional actuarial experience Requires advanced experience and skillset in Microsoft Excel and/or SAS/SQL Requires strong communication and presentation skills  Requires strong ability to communicate complex technical subjects to non-technical audiences Desires some level of experience in Visualization tool like Tableau and Machine Learning basics Desires a curious mindset and eagerness to learn Prior healthcare industry experience preferred

Created: 2025-05-01