Actuarial Analyst, Senior

Blue Shield of California - Long Beach, CA

Full-time - Mid Level

Long Beach, CA

Insurance Carriers and Related Activities

About the position

The Senior Actuarial Analyst position at Blue Shield of California involves performing financial analyses and modeling to support provider contracting for CalPERS. This role focuses on understanding and applying various analytic methods to assess risk, develop pricing strategies, and improve operational efficiencies within the provider network.

Responsibilities

• Understand core principles and functionality of decision, descriptive, and predictive analytic methods.
• Conduct and develop analysis, assess risk and population risk scores, and develop pricing and trends.
• Coordinate, prepare, perform, and audit actuarial analyses for complex formulations.
• Perform data exploration using statistical programming languages and deploy predictive analytics.
• Develop evaluation and 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.
• Reprice historical data against provider contract terms.
• 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.
• Knowledge of SAS is preferred.