Actuarial Analyst, Senior

BlueShield Of California - Oakland, CA

Full-time - Mid Level

Oakland, CA

About the position

The Senior Actuarial Analyst will be a key member of the Network and Provider Analytics team, responsible for performing financial analyses and modeling to support provider contracting for CalPERS. This role involves utilizing advanced analytical methods to assess risks, develop pricing strategies, and evaluate provider reimbursement terms, ultimately contributing to the development of an affordable provider network.

Responsibilities

• Understand core principles of decision, descriptive, and predictive analytic methods including forecasting and statistical techniques.
• Conduct financial analyses, assess risk, develop pricing and trends, and analyze provider reimbursement terms.
• Coordinate and audit actuarial analyses to recommend pricing, trending, reserving, and risk assessment strategies.
• Perform data exploration using statistical programming languages such as R, Python, SQL, and SAS.
• Develop financial reporting standards for internal and external reports.
• Conduct independent analysis of high complexity and develop novel analyses and reports.
• Create financial unit cost trend reporting and rate calculations using Excel modeling tools.
• Run and maintain SAS queries for complex financial analysis.
• Analyze CalPERS PPO contract rate proposals to assess financial and trend impact.
• Partner with network management to maintain and develop the CalPERS PPO provider network.

Requirements

• Bachelor's degree with a minor in mathematics, statistics, computer science, or equivalent business experience.
• Minimum of 3 years of professional actuarial experience.
• 2 years of experience in Health Care (managed care, academic, or government payer).
• Experience analyzing healthcare claims data, trends, and forecasting.
• Proficiency in Excel and comfort working with large data sets.

Nice-to-haves

• Knowledge of SAS is preferred.

Benefits

• Competitive salary range of $99,000 to $148,500 based on experience and location.